Caring communications: how technology enhances interpersonal relations, Part II.

PubMed

Simpson, Roy L

2008-01-01

Part I of this 2-part series about technology's role in interpersonal communications examined how humans interact; proposed a caring theory of communication, collaboration, and conflict resolution; and delineated ways that technology--in general--supports this carative model of interpersonal relations. Part II will examine the barriers to adoption of carative technologies, describe the core capabilities required to overcome them, and discuss specific technologies that can support carative interpersonal relationships.

The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care

PubMed Central

Roter, Debra L.; Carson, Kathryn A.; Beach, Mary Catherine; Sabin, Janice A.; Greenwald, Anthony G.; Inui, Thomas S.

2012-01-01

Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and patient ratings. Results. Among Black patients, general race bias was associated with more clinician verbal dominance, lower patient positive affect, and poorer ratings of interpersonal care; race and compliance stereotyping was associated with longer visits, slower speech, less patient centeredness, and poorer ratings of interpersonal care. Among White patients, bias was associated with more verbal dominance and better ratings of interpersonal care; race and compliance stereotyping was associated with less verbal dominance, shorter visits, faster speech, more patient centeredness, higher clinician positive affect, and lower ratings of some aspects of interpersonal care. Conclusions. Clinician implicit race bias and race and compliance stereotyping are associated with markers of poor visit communication and poor ratings of care, particularly among Black patients. PMID:22420787

Nursing Care Interpersonal Relationship Questionnaire: elaboration and validation 1

PubMed Central

Borges, José Wicto Pereira; Moreira, Thereza Maria Magalhães; de Andrade, Dalton Franscisco

2018-01-01

ABSTRACT Objective: to elaborate an instrument for the measurement of the interpersonal relationship in nursing care through the Item Response Theory, and the validation thereof. Method: methodological study, which followed the three poles of psychometry: theoretical, empirical and analytical. The Nursing Care Interpersonal Relationship Questionnaire was developed in light of the Imogene King’s Interpersonal Conceptual Model and the psychometric properties were studied through the Item Response Theory in a sample of 950 patients attended in Primary, Secondary and Tertiary Health Care. Results: the final instrument consisted of 31 items, with Cronbach’s alpha of 0.90 and McDonald’s Omega of 0.92. The parameters of the Item Response Theory demonstrated high discrimination in 28 items, being developed a five-level interpretive scale. At the first level, the communication process begins, gaining a wealth of interaction. Subsequent levels demonstrate qualitatively the points of effectiveness of the interpersonal relationship with the involvement of behaviors related to the concepts of transaction and interaction, followed by the concept of role. Conclusion: the instrument was created and proved to be consistent to measure interpersonal relationship in nursing care, as it presented adequate reliability and validity parameters. PMID:29319743

Residents' experiences of interpersonal factors in nursing home care: a qualitative study.

PubMed

Nakrem, Sigrid; Vinsnes, Anne Guttormsen; Seim, Arnfinn

2011-11-01

With life expectancy lengthening, the number of those who will require care in a nursing home will increase dramatically in the next 20 years. Nursing home residents are frail older adults with complex needs, dependent on advanced nursing care. Long-term residents in nursing homes have long-term relationships with the nurses, which require a unique approach to the interpersonal aspects of nursing care. Understanding what is experienced as care quality, including quality of interpersonal processes, requires insight into the residents' perspectives for best value in care to be realized. Main objective was to describe the nursing home residents' experience with direct nursing care, related to the interpersonal aspects of quality of care. A descriptive, exploratory design was used. Four public municipal nursing homes in Norway with long-term residents were purposely selected for the study. Fifteen mentally lucid residents were included. The inclusion criteria were aged 65 and over, being a resident of the nursing home for one month or longer, and physical and mental capacity to participate in the interview. In-depth interviews with the residents were performed. The transcribed interviews were analyzed using meaning categorizing. The residents emphasized the importance of nurses acknowledging their individual needs, which included need for general and specialized care, health promotion and prevention of complications, and prioritizing the individuals. The challenging balance between self-determination and dependency, the altered role from homeowner to resident, and feelings of indignity and depreciation of social status were key issues in which the residents perceived that their integrity was at risk in the patient-nurse interaction and care. Psychosocial well-being was a major issue, and the residents expressed an important role of the nursing staff helping them to balance the need for social contact and to be alone, and preserving a social network. Quality nursing care in nursing home implies a balanced, individual approach to medical, physical and psychosocial care, including interpersonal aspects of care. The interpersonal relationship between resident and nurse implies long-term commitment, reciprocal relationship on a personal level and interpersonal competence of the nurses to understand each resident's needs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Association of the quality of interpersonal care during family planning counseling with contraceptive use.

PubMed

Dehlendorf, Christine; Henderson, Jillian T; Vittinghoff, Eric; Grumbach, Kevin; Levy, Kira; Schmittdiel, Julie; Lee, Jennifer; Schillinger, Dean; Steinauer, Jody

2016-07-01

Health communication and interpersonal skills are increasingly emphasized in the measurement of health care quality, yet there is limited research on the association of interpersonal care with health outcomes. As approximately 50% of pregnancies in the United States are unintended, whether interpersonal communication influences contraceptive use is of public health importance. The aim of this study was to determine whether the quality of interpersonal care during contraceptive counseling is associated with contraceptive use over time. The Patient-Provider Communication about Contraception study is a prospective cohort study of 348 English-speaking women seen for contraceptive care, conducted between 2009 and 2012 in the San Francisco Bay Area. Quality of communication was assessed using a patient-reported interpersonal quality in family planning care measure based on the dimensions of patient-centered care. In addition, the clinical visit was audio recorded and its content coded according to the validated Four Habits Coding Scheme to assess interpersonal communication behaviors of clinicians. The outcome measures were 6-month continuation of the selected contraceptive method and use of a highly or moderately effective method at 6 months. Results were analyzed using mixed effect logistic regression models controlling for patient demographics, the clinic and the provider at which the visit occurred, and the method selected. Patient participants had a mean age of 26.8 years (SD 6.9 years); 46% were white, 26% Latina, and 28% black. Almost two-thirds of participants had an income of <200% of the Federal Poverty Level. Most of the women (73%) were making visits to a provider whom they had not seen before. Of the patient participants, 41% were still using their chosen contraceptive method at 6-month follow-up. Patients who reported high interpersonal quality of family planning care were more likely to maintain use of their chosen contraceptive method (adjusted odds ratio [aOR], 1.8; 95% CI, 1.1-3.0) and to be using a highly or moderately effective method at 6 months (aOR, 2.0; 95% CI, 1.2-3.5). In addition, 2 of the Four Habits were associated with contraceptive continuation; "invests in the beginning" (aOR, 2.3; 95% CI, 1.2-4.3) and "elicits the patient's perspective" (aOR, 1.8; 95% CI, 1.0-3.2). Our study provides evidence that the quality of interpersonal care, measured using both patient report and observation of provider behaviors, influences contraceptive use. These results provide support for ongoing attention to interpersonal communication as an important aspect of health care quality. The associations of establishing rapport and eliciting the patient perspective with contraceptive continuation are suggestive of areas of focus for provider communication skills training for contraceptive care. Copyright © 2016 Elsevier Inc. All rights reserved.

Teaching interpersonal skills in family practice: results of a national survey.

PubMed

Kahn, G; Cohen, B; Jason, H

1979-02-01

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.

Welcome to cultural competency: surgery's efforts to acknowledge diversity in residency training.

PubMed

Ly, Catherine L; Chun, Maria B J

2013-01-01

Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

PubMed

Cheraghi-Sohi, Sudeh; Bower, Peter

2008-08-21

Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii) Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these interventions are routinely introduced to improve patient satisfaction with interpersonal care in primary care. The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

Peace in the Clinic: Rethinking "Global Health Diplomacy" in the Somali Region of Ethiopia.

PubMed

Carruth, Lauren

2016-06-01

Drawing on ethnographic research with Somalis, within aid organizations, and within health care facilities in the Somali Region of Ethiopia, this article argues that what is called "global health diplomacy," despite its origins and articulations in interstate politics, is fundamentally local and interpersonal. As evidence, I outline two very different health programs in the Somali Region of Ethiopia, and how, in each, existing animosities and political grievances were either reinforced or undermined. I argue that the provision of health care in politically insecure and post-conflict settings like the Somali Region of Ethiopia is precarious but pivotal: medical encounters have the potential to either worsen the conditions in which conflicts and crises recur, or build new interpersonal and governmental relations of trust. Effective global health diplomacy, therefore, cannot be limited to building clinics and donating medicine, but must also explicitly include building positive relationships of trust between oppositional groups within clinical spaces.

Effectiveness of an interpersonal relationship program on interpersonal relationships, self-esteem, and depression in nursing students.

PubMed

Yoon, Hee Sang; Kim, Gyung Hee; Kim, Jiyoung

2011-12-01

The purpose of this study was to examine the effectiveness of an interpersonal relationship program on interpersonal relationships, self-esteem, and depression in nursing students. This was a quasi-experiment with a nonequivalent control group pre-posttest design. Sixty-four nursing students participated in the study with 31 in the experimental group and 33 in the control group. They were from 3 different colleges of nursing located in Seoul. The interpersonal relationship program was held 10 times over 10 weeks, taking 90 minutes per session. The interpersonal relationship change scale developed by Schlein and Guemey, Rosenberg's self-esteem scale, and CED-S for depression were the instruments used in the study. The data collection period was from January 4 to March 8, 2011, and the collected data were analyzed with SPSS 14.0 using the Χ(2)-test, t-test, and paired t-test. The results showed a significant difference between the experimental group and the control group in terms of the degree of interpersonal relationships, self-esteem, and depression. The results indicate that interpersonal relationship programs have positive effects for improving interpersonal relationships and self-esteem, and decreasing depression in nursing students.

Medical student empathy: interpersonal distinctions and correlates.

PubMed

Jordan, Kevin D; Foster, Penni Smith

2016-12-01

Attention to interpersonal behaviors, communication, and relational factors is taking on increasing importance in medical education. Medical student empathy is one aspect of the physician-patient relationship that is often involved in beneficial interactions leading to improved clinical outcomes and patient satisfaction. As an interpersonal quality, empathy is a social behavior well-suited to be examined from an interpersonal perspective. The present study used the interpersonal theory of clinical, personality, and social psychology to examine the construct of empathy and theorize about likely interpersonal correlates. One hundred and sixty-three students from an academic health center in the southeastern United States participated in this study. The medical student version of the Jefferson Scale of Empathy was used to assess empathy and its factors: Perspective taking, compassionate care, and walking in the patient's shoes. Interpersonal assessments included the International Personality Item Pool-Interpersonal Circumplex, the Interpersonal Support Evaluation List, and the UCLA Loneliness Scale. Distinct interpersonal styles and correlates emerged among empathy and its factors. While all factors of empathy were related to interpersonal warmth, perspective taking and compassionate care were also associated with submissiveness. Of note, only walking in the patient's shoes was correlated with both social support and less loneliness. These findings are discussed in light of interpersonal theory with particular attention paid to the implications for medical education and professional development.

Recruitment, Promotion and Retention of Women in Academic Medicine: How Institutions Are Addressing Gender Disparities

PubMed Central

Carr, Phyllis L.; Gunn, Christine; Raj, Anita; Kaplan, Samantha; Freund, Karen M.

2017-01-01

Objective Greater numbers of women in medicine have not resulted in more women achieving senior positions. Programs supporting recruitment, promotion and retention of women in academic medicine could help to achieve greater advancement of more women to leadership positions. Qualitative research was conducted to understand such programs at 23 institutions and, using the social ecological model, examine how they operate at the individual, interpersonal, institutional, academic community and policy levels. Methods Telephone interviews were conducted with faculty representatives (N=44) of the Group on Women in Medicine and Science (GWIMS), Diversity and Inclusion (GDI) or senior leaders with knowledge on gender climate in 24 medical schools. Four trained interviewers conducted semi-structured interviews that addressed faculty perceptions of gender equity and advancement, which were audio-taped and transcribed. The data were categorized into three content areas: recruitment, promotion and retention, and coded a priori for each area based on their social ecological level of operation. Findings Participants from nearly 40% of the institutions reported no special programs for recruiting, promoting or retaining women, largely describing such programming as unnecessary. Existing programs primarily targeted the individual and interpersonal levels simultaneously, via training, mentoring, and networking, or the institutional level, via search committee trainings, child and elder care, and spousal hiring programs. Lesser effort at the academic community and policy levels were described. Conclusions Our findings demonstrate that many US medical schools have no programs supporting gender equity among medical faculty. Existing programs primarily target the individual or interpersonal level of the social ecological interaction. The academic community and broader policy environment require greater focus as levels with little attention to advancing women’s careers. Universal multi-level efforts are needed to more effectively advance the careers of medical women faculty and support gender equity. PMID:28063849

Experiences of stigma, discrimination, care and support among people living with HIV: A four country study

PubMed Central

Neuman, Melissa; Obermeyer, Carla Makhlouf; Cherutich, Peter; Desclaux, Alice; Hardon, Anita; Ky-Zerbo, Odette; Namakhoma, Ireen; Wanyenze, Rhoda

2013-01-01

While it is widely agreed that HIV-related stigma may impede access to treatment and support, there is little evidence describing who is most likely to experience different forms of stigma and discrimination and how these affect disclosure and access to care. This study examined experiences of interpersonal discrimination, internalized stigma, and discrimination at health care facilities among HIV-positive adults aged 18 years and older utilizing health facilities in four countries in Sub-Saharan Africa (N=536). Prevalence of interpersonal discrimination across all countries was 34.6%, with women significantly more likely to experience interpersonal discrimination than men. Prevalences of internalized stigma varied across countries, ranging from 9.6% (Malawi) to 45.0% (Burkina Faso). Prevalence of health care discrimination was 10.4% across all countries. In multivariate analyses, we found positive, significant, and independent associations between disclosure and interpersonal discrimination and support group utilization, and positive associations between both internalized stigma and health care discrimination and referral for medications. PMID:23479002

Interpersonal relations between health care workers and young clients: barriers to accessing sexual and reproductive health care.

PubMed

Alli, Farzana; Maharaj, Pranitha; Vawda, Mohammed Yacoob

2013-02-01

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level.

Foster Care: Creating Interpersonal Change through Story-Telling and Family Play. Strategies to Support Client Assessment and Intervention.

ERIC Educational Resources Information Center

Schatz, Mona Struhsaker; Gaddis, Stephen R.; Zimmerman, Toni Schindler

Story-telling and family play can exert powerful effects on children. Some beliefs, values, and personal life-style choices that relate to how play is created are examined. Using the primary concepts in "narrative therapy,""adventure-based programming," and "family play therapy," play is employed to create an empowerment framework to consider the…

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

PubMed

Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.

PubMed

Coupet, Edouard; Karp, David; Wiebe, Douglas J; Kit Delgado, M

2018-03-28

Investment in violence prevention programs is hampered by lack of clearly identifiable stakeholders with a financial stake in prevention. We determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. We analyzed all emergency department (ED) visits from 2009 to 2014 with diagnosis codes for violent injury in the Nationwide Emergency Department Sample (NEDS). We used sample weights to estimate total charges with adjusted generalized linear models to estimate charges for the 15% of ED visits with missing charge data. We then calculated the share attributable by payer and determined the difference in proportion by payer from 2013 to 2014. Between 2009 and 2013, the uninsured accounted for 28.2-31.3% of annual charges for the acute care of violent injury, while Medicaid was responsible for a similar amount (29.0-31.0%). In 2014, there were $10.7 billion in total charges for violent injury. Medicaid assumed the greatest share, 39.8% (95% CI: 38.0-41.5%, $3.5-5.1 billion), while the uninsured accounted for 23.6% (95% CI: 22.2-24.9%, $2.0-3.0 billion), and Medicare accounted for 7.8% (95% CI: 7.7-8.0%, $0.7-1.0 billion). After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. These findings highlight the benefit to state Medicaid programs of preventing interpersonal violence. Published by Elsevier Inc.

Patients Provide Recommendations for Improving Patient Satisfaction.

PubMed

Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

2016-04-01

National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Evaluation of Competencies Related to Personal Attributes of Resident Doctors by 360 Degree.

PubMed

Jani, Harsha; Narmawala, Wasea; Ganjawale, Jaishree

2017-06-01

Postgraduate teaching involves training the residents in all spheres including professionalism, communication and interpersonal skills in addition to the basic clinical skills. Therefore, 360 degree evaluation has gained focus due to increased standards of medical care as shown in this study. To evaluate interpersonal and communication skills and professionalism in residents doctors using 360 degree evaluation method. The present study was a descriptive study conducted at a tertiary care hospital affiliated with a medical college. Taking up as a pilot project, 26 residents from four departments were recruited in this study. A five point likert scale (1 to 5,1 meaning poor, 5 meaning excellent) was used for scoring them on for their interpersonal and communication skills and professionalism by the persons working around their sphere like teachers, peers, nursing staff, undergraduate students and patients/or relatives (360 degree). Though the ratings by the peers and consultants were found to be slightly lower compared with nursing staff, undergraduate students and patients, there was good agreement between all of them. The mean score of all traits showed an increasing trend over the years of residency. Regular orientation programs for professionalism with 360 degree evaluation and subsequent feedback to the resident doctor about their strength and weaknesses can definitely bring out behavioural change in the resident doctor in practice.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

PubMed

Northam, Holly L; Hercelinskyj, Gylo; Grealish, Laurie; Mak, Anita S

2015-11-01

Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning development and competence to manage culturally complex clinical issues such as end of life care, and is recommended as a framework for health care students to learn the skills required to provide culturally competent care in a range of culturally complex health care settings. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Nursing praxis, compassionate caring and interpersonal relations: an observational study.

PubMed

Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

2013-05-01

The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

Technology, Educator Intention, and Relationships in Virtual Learning Spaces: A Qualitative Metasynthesis.

PubMed

Gdanetz, Lorraine M; Hamer, Mika K; Thomas, Eileen; Tarasenko, Lindsey M; Horton-Deutsch, Sara; Jones, Jacqueline

2018-04-01

A main concern that remains with the continued growth of online nursing education programs is the way educator and student relationships can be affected by new technologies. This interpretive study aims to gain an understanding of how technology influences the development of interpersonal relationships between the student and faculty in a virtual learning environment. Using an established structured approach to qualitative metasynthesis, a search was conducted using PubMed, EBSCO, CINAHL, Medline, ProQuest, Ovid Nursing databases, and Google Scholar, focused on caring and relational aspects of online nursing education. Technology alters communication, thereby positioning the intentionality of the educator at the heart of interpersonal relationship development in virtual learning spaces. This interpretive synthesis of prior qualitative research supports the development of a framework for online nursing courses, the need for continuing education of nursing faculty, the value of caring intentions, and enhancement of the educator's technological proficiency. [J Nurs Educ. 2018;57(4):197-202.]. Copyright 2018, SLACK Incorporated.

An exploration of contextual dimensions impacting goals of care conversations in postgraduate medical education.

PubMed

Roze des Ordons, Amanda L; Lockyer, Jocelyn; Hartwick, Michael; Sarti, Aimee; Ajjawi, Rola

2016-03-21

Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations between trainees and patients/families about goals of care in the acute care setting. We conducted an exploratory qualitative study involving five focus groups with Internal Medicine trainees (n = 20) and a series of interviews with clinical faculty (n = 11) within a single Canadian centre. Thematic framework analysis was applied to categorize the data and identify themes and subthemes. Challenges and factors enabling goals of care conversations emerged within individual, interpersonal and system dimensions. Challenges included inadequate preparation for these conversations, disconnection between trainees, faculty and patients, policies around documentation, the structure of postgraduate medical education, and resource limitations; these challenges led to missed opportunities, uncertainty and emotional distress. Enabling factors were awareness of the importance of goals of care conversations, support in these discussions, collaboration with colleagues, and educational initiatives enabling skill development; these factors have resulted in learning, appreciation, and an established foundation for future educational initiatives. Contextual factors impact how postgraduate medical trainees communicate with patients/families about goals of care. Attention to individual, interpersonal and system-related factors will be important in designing educational programs that help trainees develop the capacities needed for challenging conversations.

The role of context and the interpersonal experience of loneliness among older people in a residential care facility.

PubMed

Roos, Vera; Malan, Lelanie

2012-10-11

Older people are more prone to experience loneliness when living in residential care facilities. The purpose of this study was to explore older people's experiences of loneliness in the context of institutionalized care. A voluntary and convenience-based sample of 10 white South African older people (age range 62 to 82 years; three men and seven women) was drawn. Data on the subjective experience of loneliness were then gathered through the Mmogo-method, whereby drawings were employed to explore matters and issues of importance in the lives of older people that could be used to deal with loneliness. Data were analyzed thematically and visually as well as through the use of keywords in context. The results showed that older people experienced loneliness in terms of having unavailable interactions due to loss, and an absence of meaningful interpersonal interactions. Meaningful interpersonal interactions were described as when the older people had regular contact and a variety of interactions. Ineffective interpersonal styles (e.g. taking a controlling position in relationships and being rigid) elicited rejection and isolation, and were associated with a lack of confirmatory interpersonal relationships. It is recommended that greater emphasis should be placed on creating awareness of unhealthy group dynamics as well as on psychosocial interventions to develop group support. Interpersonal styles, either effective or ineffective, take place in a social context, which, in this research, was observed to be unsafe, lacking in care, and a non-stimulating environment.

Posttraumatic Stress Disorder and Interpersonal Process in Homeless Veterans Participating in a Peer Mentoring Intervention: Associations With Program Benefit.

PubMed

Van Voorhees, Elizabeth E; Resnik, Linda; Johnson, Erin; O'Toole, Thomas

2018-01-25

Homelessness among veterans has dropped dramatically since the expansion of services for homeless veterans in 2009, and now engaging homeless veterans in existing programs will be important to continuing to make progress. While one promising approach for engaging homeless veterans in care is involving peer mentors in integrated services, posttraumatic stress disorder (PTSD) may diminish the effects of peer mentorship. This mixed methods study examined how interpersonal and emotional processes in homeless veterans with and without PTSD impacted their capacity to engage in relationships with peer mentors. Four focus groups of 5-8 homeless male veterans (N = 22) were drawn from a larger multisite randomized trial. Qualitative analysis identified five primary themes: disconnectedness; anger, hostility, or resentment; connecting with others; positive view of self; and feeling like an outsider. Thematic comparisons between participants with and without a self-reported PTSD diagnosis, and between those who did and did not benefit from the peer mentor program, were validated by using quantitative methods. Disconnectedness was associated with self-reported PTSD diagnosis and with lack of program benefit; feeling like an outsider was associated with program benefit. Results suggest that disruption to the capacity to develop and maintain social bonds in PTSD may interfere with the capacity to benefit from peer mentorship. Social rules and basic strategies for navigating interpersonal relationships may differ somewhat within the homeless community and outside of it; for veterans who feel disconnected from the domiciled community, a formerly homeless veteran peer may serve as a critical "bridge" between the two social worlds. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Recruitment, Promotion, and Retention of Women in Academic Medicine: How Institutions Are Addressing Gender Disparities.

PubMed

Carr, Phyllis L; Gunn, Christine; Raj, Anita; Kaplan, Samantha; Freund, Karen M

Greater numbers of women in medicine have not resulted in more women achieving senior positions. Programs supporting the recruitment, promotion, and retention of women in academic medicine could help to achieve greater advancement of more women to leadership positions. Qualitative research was conducted to understand such programs at 23 institutions and, using the social ecological model, examine how they operate at the individual, interpersonal, institutional, academic community, and policy levels. Telephone interviews were conducted with faculty representatives (n = 44) of the Group on Women in Medicine and Science, Diversity and Inclusion, or senior leaders with knowledge on gender climate in 24 medical schools. Four trained interviewers conducted semistructured interviews that addressed faculty perceptions of gender equity and advancement, which were audiotaped and transcribed. The data were categorized into three content areas-recruitment, promotion, and retention-and coded a priori for each area based on their social ecological level of operation. Participants from nearly 40% of the institutions reported no special programs for recruiting, promoting, or retaining women, largely describing such programming as unnecessary. Existing programs primarily targeted the individual and interpersonal levels simultaneously, via training, mentoring, and networking, or the institutional level, via search committee trainings, child and elder care, and spousal hiring programs. Lesser effort at the academic community and policy levels were described. Our findings demonstrate that many U.S. medical schools have no programs supporting gender equity among medical faculty. Existing programs primarily target the individual or interpersonal level of the social ecological interaction. The academic community and broader policy environment require greater focus as levels with little attention to advancing women's careers. Universal multilevel efforts are needed to more effectively advance the careers of medical women faculty and support gender equity. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Homeless youths' interpersonal perspectives of health care providers.

PubMed

Hudson, Angela L; Nyamathi, Adeline; Sweat, Jeff

2008-12-01

In the United States, youth run away from home due to poor interpersonal relationships with parents or guardians; often times, they have been the recipients of parental neglect or abuse. As youth become increasingly entrenched in street-based living and problem substance use, their ability to rehabilitate their lives is incumbent upon trusting and engaging relationships with adult service providers. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups to provide their perspectives on encounters and interpersonal relationships with health care providers. Participants were recruited from shelters in Hollywood, California, and from a drop-in shelter in Santa Monica, California. Four themes related to interpersonal barriers to care from service providers were identified: authoritative communication, one-way communication, disrespect, and empathy. Participants appreciate care providers who convey information in a helpful, meaningful manner and prefer providers who can, themselves, share similar life experiences. Implications point to the need for agencies and services specifically tailored to homeless, drug-using youth. These agencies should employ care providers who are trained to understand the developmental needs and histories of runaway youth. For proper reintegration of this vulnerable population into mainstream society, the narratives of these youth underscore the necessity of targeted services.

Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training.

PubMed

O'Sullivan, Patricia; Chao, Serena; Russell, Matthew; Levine, Sharon; Fabiny, Anne

2008-09-01

Teaching and assessment of communication and interpersonal skills, one of the American Council for Graduate Medical Education-designated core competencies, is an important but difficult task in the training of physicians. Assessment of trainees offers an opportunity to provide explicit feedback on their skills and encourages learning. This article describes a pilot study in which clinician-educators affiliated with the geriatrics training programs at Beth Israel Deaconess Medical Center and Boston University Medical Center designed and piloted a novel Objective Structured Clinical Examination (OSCE) to assess the communication and interpersonal skills of medical, dental, and geriatric psychiatry fellows. The OSCE consisted of three stations where geriatricians and standardized patients evaluated candidates using specifically designed checklists and an abbreviated version of the Master Interview Rating Scale. Communication skills were assessed through performance of specific "real life" clinical tasks, such as obtaining a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions, and counseling. Interpersonal skills were assessed through the effect of the communication between doctor and standardized patient on fostering trust, relieving anxiety, and establishing a therapeutic relationship. This pilot study demonstrated that the OSCE format of assessment provides a valid means of evaluating the communication and interpersonal skills of interdisciplinary geriatric trainees and provides a valuable forum for formative assessment and feedback. Given that geriatricians and non geriatricians involved in elder care both need communication and interpersonal skills, this novel OSCE can be used for assessment of these skills in trainees in diverse healthcare subspecialties.

The association among interpersonal problems, binge behaviors, and self-esteem, in the assessment of obese individuals.

PubMed

Lo Coco, Gianluca; Gullo, Salvatore; Salerno, Laura; Iacoponelli, Rosalia

2011-01-01

Although disordered eating has been assumed to be associated with interpersonal problems, there is a lack of research regarding the relationship between interpersonal problems and obesity. This study explored associations among self-esteem, binge behaviors, and interpersonal problems in obese individuals, by contrasting obese persons with overweight persons, and to investigate whether body mass index (BMI), binge behaviors, and self-esteem predict interpersonal problems in obese individuals. A group of nonobese overweight people (n = 65; BMI range, 25-29.9 kg/m²) and a group of obese people (n = 78; BMI >35 kg/m²) were selected from 224 people attending a mental health care service specializing in eating disorders in Palermo (Italy). Seventy-eight percent of participants were female. All participants filled in the following measures: the Inventory of Interpersonal problems-short version, the Binge Eating Scale, and the Rosenberg Self-esteem Scale. The findings showed that 4 domains of interpersonal problems were associated with binge behaviors and self-esteem in obese participants. Moreover, the relationship between binge behaviors and interpersonal problems was partially mediated by self-esteem. Given the poor prognosis for the long-term management of obesity, it could be important for clinicians to carefully assess patients' interpersonal functioning and its relationship to self-esteem and binge behaviors, especially with respect to treatment-seeking obese patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Educational Research Report: Changes in Students' Levels of Empathy during the Didactic Portion of a Veterinary Program.

PubMed

Schoenfeld-Tacher, Regina M; Kogan, Lori R; Meyer-Parsons, Beatrice; Royal, Kenneth D; Shaw, Jane R

2015-01-01

Empathy can be defined as the ability to understand and connect with the emotional state and frame of mind of another. Establishing connections with others is a crucial skill for veterinarians who must earn the trust and compliance of their clients to provide quality care for their patients. This is a longitudinal study using the Davis Interpersonal Reactivity Index (IRI) to assess changes in veterinary students' self-reported empathy as they progressed through the didactic portion of the DVM program at Colorado State University. The IRI consists of four subscales that measure cognitive and affective components of empathy: Perspective Taking, Fantasy, Emphatic Concern, and Personal Distress. Data were collected at three time points, corresponding to the start of the first year, the fourth semester (second year), and the fifth semester (third year). Results showed an overall decline in Perspective Taking scores, with a significant decrease between first and second year. There was an overall increase in students' levels of Personal Distress as they progressed through the program. The significant difference was found between years 1 and 3. This is especially concerning because the enhanced unease in interpersonal interactions coincides with students entering clinical rotations in the third year-the very time when these traits are necessary for quality client and patient care. Veterinary educators are urged to use this information as a basis for investigating novel curricular and programmatic interventions to counteract these changes in student empathy.

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning.

PubMed

Joyce, Anthony S; Ogrodniczuk, John S; Kealy, David

2017-01-01

Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment-a comprehensive and intensive group-oriented outpatient therapy program-offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change. Consecutively admitted patients (N = 75) to a group-oriented evening treatment program were recruited; the majority were diagnosed with personality disorder. Therapy outcome was represented by scores on the Inventory of Interpersonal Problems. Follow-up outcome was represented by the global score of the Social Adjustment Scale. Group climate, group cohesion, and the therapeutic alliance were examined as process variables. Patients experienced substantial reduction in distress associated with interpersonal problems; early process factors that reflected a cohesive and engaged group climate and stronger therapeutic alliance were predictive of this outcome. Improvement in interpersonal distress was predictive of global social functioning six months later. The therapeutic alliance most strongly accounted for change in interpersonal problems at posttreatment and social functioning at follow-up. A comprehensive and integrated outpatient group therapy program, offered in the evening to accommodate patients' real-life demands, can facilitate considerable improvement in interpersonal problems, which in turn influences later social functioning. The intensity and intimacy of peer interactions in the therapy groups, and a strong alliance with the program therapists, are likely interacting factors that are particularly important to facilitate such change.

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

PubMed Central

Eisen, Jeffrey C.; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy

2013-01-01

Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912 PMID:24800110

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives.

PubMed

Eisen, Jeffrey C; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy; Van Voorhees, Benjamin W

2013-01-01

To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912.

Mental Health Pathways from Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men

ERIC Educational Resources Information Center

Pantalone, David W.; Hessler, Danielle M.; Simoni, Jane M.

2010-01-01

Objective: We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban…

Integrating Technology and Interpersonal Communication To Prepare HDFS Majors for the Future.

ERIC Educational Resources Information Center

Yaure, Robin G.; Christiansen, Shawn L.

1999-01-01

Surveys students to evaluate a new Human Development and Family Studies (HDFS) baccalaureate program at the Pennsylvania State University Commonwealth College. The program emphasizes the link between technology and interpersonal communication. Results show that the program's primary success has been with improving students' comfort level and hence…

The experimentation of LC7E learning model on the linear program material in terms of interpersonal intelligence on Wonogiri vocational school students

NASA Astrophysics Data System (ADS)

Antinah; Kusmayadi, T. A.; Husodo, B.

2018-05-01

This study aims to determine the effect of learning model on student achievement in terms of interpersonal intelligence. The compared learning models are LC7E and Direct learning model. This type of research is a quasi-experimental with 2x3 factorial design. The population in this study is a Grade XI student of Wonogiri Vocational Schools. The sample selection had done by stratified cluster random sampling. Data collection technique used questionnaires, documentation and tests. The data analysis technique used two different unequal cell variance analysis which previously conducted prerequisite analysis for balance test, normality test and homogeneity test. he conclusions of this research are: 1) student learning achievement of mathematics given by LC7E learning model is better when compared with direct learning; 2) Mathematics learning achievement of students who have a high level of interpersonal intelligence is better than students with interpersonal intelligence in medium and low level. Students' mathematics learning achievement with interpersonal level of intelligence is better than those with low interpersonal intelligence on linear programming; 3) LC7E learning model resulted better on mathematics learning achievement compared with direct learning model for each category of students’ interpersonal intelligence level on linear program material.

The experimentation of LC7E learning model on the linear program material in terms of interpersonal intelligence on Wonogiri Vocational School students

NASA Astrophysics Data System (ADS)

Antinah; Kusmayadi, T. A.; Husodo, B.

2018-03-01

This study aimed to determine the effect of learning model on student achievement in terms of interpersonal intelligence. The compared learning models are LC7E and Direct learning model. This type of research is a quasi-experimental with 2x3 factorial design. The population in this study is a Grade XI student of Wonogiri Vocational Schools. The sample selection had done by stratified cluster random sampling. Data collection technique used questionnaires, documentation and tests. The data analysis technique used two different unequal cell variance analysis which previously conducted prerequisite analysis for balance test, normality test and homogeneity test. he conclusions of this research are: 1) student learning achievement of mathematics given by LC7E learning model is better when compared with direct learning; 2) Mathematics learning achievement of students who have a high level of interpersonal intelligence is better than students with interpersonal intelligence in medium and low level. Students’ mathematics learning achievement with interpersonal level of intelligence is better than those with low interpersonal intelligence on linear programming; 3) LC7E learning model resulted better on mathematics learning achievement compared with direct learning model for each category of students’ interpersonal intelligence level on linear program material.

Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

PubMed Central

2013-01-01

Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process evaluation will also be undertaken. Discussion LEAP for Life may prove a cost-effective way to improve client engagement and other outcomes in the community setting. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612001064897. PMID:24238067

Technology acceptance and quality of life of the elderly in a telecare program.

PubMed

Chou, Chun-Chen; Chang, Chi-Ping; Lee, Ting-Ting; Chou, Hsueh-Fen; Mills, Mary Etta

2013-07-01

As information and communication technology applied to telecare has become a trend in elder care services, evaluation of the program is vital for further program design and development. This study evaluated the variables influencing the use of a telecare service program by the elderly. A questionnaire survey was used to explore the relationship between quality of life and technology acceptance of a telecare program in Taiwan. In addition, open-ended questions were used to elicit qualitative information regarding the experience of technology use. The results revealed that elderly persons with better social welfare status and health condition, who used the device frequently, had higher quality of life and accepted technology use. The correlation results also indicated that elderly persons who perceived telecare as useful in solving health problems, had the intention to use the program, and were willing to continue use, also had a better perception toward quality of life regarding their interpersonal relationships and living environment. Nonetheless, cost may be an issue that will impede their willingness to use the technology in care service.

Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan.

PubMed

Chen, Chi-Chen; Cheng, Shou-Hsia

2010-11-01

To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan. Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care. The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; p<0.001), indicating that the interpersonal skill level increases in competition. A similar association was found for the perceived clinical competence (coefficient of -0.457; p=0.001). Quality of care from the patients' perspective is sensitive to the degree of competition. By using patient-reported data, this study provides new evidence concerning competition and quality of care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Interpersonal violence: quantifying the burden of injury in a South African trauma centre.

PubMed

Bola, Sumrit; Dash, Isabella; Naidoo, Maheshwar; Aldous, Colleen

2016-03-01

Interpersonal violence is an epidemic in South Africa and remains an under-reported and expensive burden on health resources. In most of the developing world there is little or no descriptive information about the expense of treating the consequences of interpersonal violence. To review the direct burden of interpersonal violence on a tertiary hospital in Northern KwaZulu-Natal, an area known to have high rates of poverty and violent crime. A retrospective case note review of emergency hospital admissions between January and March 2013 was carried out. The reports included demographic characteristics, admitting diagnosis and surgical management. Case files were reviewed to determine cost drivers, such as radiological investigations, blood products, theatre usage and specialist care. Trauma accounted for 374 hospital admissions from the emergency department, of which 142 (38%) were attributable to interpersonal violence (16% of total admissions). One hundred and fifty-six hospital bed days were used over the study period. The average inpatient stay was 9.8 days with 58% requiring a resuscitation bed on admission. One-third of patients underwent emergency surgery and eight patients required postoperative intensive care. The minimum hospital expenditure for interpersonal violence injuries over 3 months was R8 367 788 ($783 960). Interpersonal violence is the source of a significant financial burden on the South African health system. Patients are often severely injured and require a high level of specialist investigations and surgical care. This study gives evidence to improve budget and workload planning for regional surgical departments and supports the need for more effective primary prevention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Barriers and Facilitators to Retaining and Reengaging HIV Clients in Care: A Case Study of North Carolina.

PubMed

Berger, Miriam B; Sullivan, Kristen A; Parnell, Heather E; Keller, Jennifer; Pollard, Alice; Cox, Mary E; Clymore, Jacquelyn M; Quinlivan, Evelyn Byrd

2016-11-01

Retention in HIV care is critical to decrease disease-related mortality and morbidity and achieve national benchmarks. However, a myriad of barriers and facilitators impact retention in care; these can be understood within the social-ecological model. To elucidate the unique factors that impact consistent HIV care engagement, a qualitative case study was conducted in North Carolina to examine the barriers and facilitators to retain and reengage HIV clients in care. HIV professionals (n = 21) from a variety of health care settings across the state participated in interviews that were transcribed and analyzed for emergent themes. Respondents described barriers to care at all levels within the HIV prevention and care system including intrapersonal, interpersonal, institutional, community, and public policy. Participants also described recent statewide initiatives with the potential to improve care engagement. Results from this study may assist other states with similar challenges to identify needed programs and priorities to optimize client retention in HIV care. © The Author(s) 2015.

Interpersonal differentiation within depression diagnosis: relating interpersonal subgroups to symptom load and the quality of the early therapeutic alliance.

PubMed

Grosse Holtforth, Martin; Altenstein, David; Krieger, Tobias; Flückiger, Christoph; Wright, Aidan G C; Caspar, Franz

2014-01-01

We examined interpersonal problems in psychotherapy outpatients with a principal diagnosis of a depressive disorder in routine care (n=361). These patients were compared to a normative non-clinical sample and to outpatients with other principal diagnoses (n=959). Furthermore, these patients were statistically assigned to interpersonally defined subgroups that were compared regarding symptoms and the quality of the early alliance. The sample of depressive patients reported higher levels of interpersonal problems than the normative sample and the sample of outpatients without a principal diagnosis of depression. Latent Class Analysis identified eight distinct interpersonal subgroups, which differed regarding self-reported symptom load and the quality of the early alliance. However, therapists' alliance ratings did not differentiate between the groups. This interpersonal differentiation within the group of patients with a principal diagnosis of depression may add to a personalized psychotherapy based on interpersonal profiles.

Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

PubMed

De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

2017-04-01

Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

The Direct and Moderating Role of School Interpersonal Climate on Children's Academic Outcomes in the Context of Whole-School, Social-Emotional Learning Programs

ERIC Educational Resources Information Center

Berg, Juliette K.; Aber, J. Lawrence

2015-01-01

A positive school climate is characterized by a supportive, orderly, and fair interpersonal climate. Children's perceptions of interpersonal climate and school safety are associated with several academic and behavioral adjustment outcomes. The current study has two goals: (1) to better understand the contribution of school interpersonal climate to…

“Could this Be Something Serious?”

PubMed Central

Hadee, Taj; Carroll, Jennifer; Meldrum, Sean C.; Lardner, Judi; Shields, Cleveland G.

2007-01-01

BACKGROUND Previous work suggests that exploration and validation of patients’ concerns is associated with greater patient trust, lower health care costs, improved counseling, and more guideline-concordant care. OBJECTIVE To describe physicians’ responses to patients’ worries, how their responses varied according to clinical context (straightforward versus medically unexplained symptoms [MUS]) and associations between their responses and patients’ ratings of interpersonal aspects of care. DESIGN Multimethod study. For each physician, we surveyed 50 current patients and covertly audiorecorded 2 unannounced standardized patient (SP) visits. SPs expressed worry about “something serious” in 2 scenarios: straightforward gastroesophageal reflux or poorly characterized chest pain with MUS. PARTICIPANTS One hundred primary care physicians and 4,746 patients. MEASUREMENTS Patient surveys measuring interpersonal aspects of care (trust, physician knowledge of the patient, satisfaction, and patient activation). Qualitative coding of 189 transcripts followed by descriptive, multivariate, and lag-sequential analyses. RESULTS Physicians offered a mean of 3.1 responses to each of 613 SP prompts. Biomedical inquiry and explanations, action, nonspecific acknowledgment, and reassurance were common, whereas empathy, expressions of uncertainty, and exploration of psychosocial factors and emotions were uncommon. Empathy expressed during SP visits was associated with higher patient ratings of interpersonal aspects of care. After adjusting for demographics and comorbidities, the association was only statistically significant for the MUS role. Empathy was most likely to occur if expressed at the beginning of the conversational sequence. CONCLUSIONS Empathy is associated with higher patient ratings of interpersonal care, especially when expressed in situations involving ambiguity. Empathy should be expressed early after patient expressions of worry. PMID:17972141

Cultural Competency Training Requirements in Graduate Medical Education

PubMed Central

Ambrose, Adrian Jacques H.; Lin, Susan Y.; Chun, Maria B. J.

2013-01-01

Background Cultural competency is an important skill that prepares physicians to care for patients from diverse backgrounds. Objective We reviewed Accreditation Council for Graduate Medical Education (ACGME) program requirements and relevant documents from the ACGME website to evaluate competency requirements across specialties. Methods The program requirements for each specialty and its subspecialties were reviewed from December 2011 through February 2012. The review focused on the 3 competency domains relevant to culturally competent care: professionalism, interpersonal and communication skills, and patient care. Specialty and subspecialty requirements were assigned a score between 0 and 3 (from least specific to most specific). Given the lack of a standardized cultural competence rating system, the scoring was based on explicit mention of specific keywords. Results A majority of program requirements fell into the low- or no-specificity score (1 or 0). This included 21 core specialties (leading to primary board certification) program requirements (78%) and 101 subspecialty program requirements (79%). For all specialties, cultural competency elements did not gravitate toward any particular competency domain. Four of 5 primary care program requirements (pediatrics, obstetrics-gynecology, family medicine, and psychiatry) acquired the high-specificity score of 3, in comparison to only 1 of 22 specialty care program requirements (physical medicine and rehabilitation). Conclusions The degree of specificity, as judged by use of keywords in 3 competency domains, in ACGME requirements regarding cultural competency is highly variable across specialties and subspecialties. Greater specificity in requirements is expected to benefit the acquisition of cultural competency in residents, but this has not been empirically tested. PMID:24404264

Rx for Tutor Training.

ERIC Educational Resources Information Center

Rubenstein, Ilene; And Others

Tutor training programs in composition which emphasize interpersonal skills while offering concentrated correctness doses of mechanics and grammar are inherently limiting. While interpersonal skills are important, they only superficially address the complex situation of tutoring. A prescription for a healthy tutor program, one which would allow…

Using program evaluation to support knowledge translation in an interprofessional primary care team: a case study.

PubMed

Donnelly, Catherine; Shulha, Lyn; Klinger, Don; Letts, Lori

2016-10-06

Evaluation is a fundamental component in building quality primary care and is ideally situated to support individual, team and organizational learning by offering an accessible form of participatory inquiry. The evaluation literature has begun to recognize the unique features of KT evaluations and has described attributes to consider when evaluating KT activities. While both disciplines have focused on the evaluation of KT activities neither has explored the role of evaluation in KT. The purpose of the paper is to examine how participation in program evaluation can support KT in a primary care setting. A mixed methods case study design was used, where evaluation was conceptualized as a change process and intervention. A Memory Clinic at an interprofessional primary care clinic was the setting in which the study was conducted. An evaluation framework, Pathways of Influence provided the theoretical foundation to understand how program evaluation can facilitate the translation of knowledge at the level of the individual, inter-personal (Memory Clinic team) and the organization. Data collection included questionnaires, interviews, evaluation log and document analysis. Questionnaires and interviews were administered both before and after the evaluation: Pattern matching was used to analyze the data based on predetermined propositions. Individuals gained program knowledge that resulted in changes to both individual and program practices. One of the key themes was the importance clinicians placed on local, program based knowledge. The evaluation had less influence on the broader health organization. Program evaluation facilitated individual, team and organizational learning. The use of evaluation to support KT is ideally suited to a primary care setting by offering relevant and applicable knowledge to primary care team members while being sensitive to local context.

Change in interpersonal problems after cognitive agoraphobia and schema-focused therapy versus psychodynamic treatment as usual of inpatients with agoraphobia and Cluster C personality disorders.

PubMed

Gude, Tore; Hoffart, Asle

2008-04-01

The aim was to study whether patients with panic disorder with agoraphobia and co-occurring Cluster C traits would respond differently regarding change in interpersonal problems as part of their personality functioning when receiving two different treatment modalities. Two cohorts of patients were followed through three months' in-patient treatment programs and assessed at follow-up one year after end of treatment. The one cohort comprised 18 patients treated with "treatment as usual" according to psychodynamic principles, the second comprised 24 patients treated in a cognitive agoraphobia and schema-focused therapy program. Patients in the cognitive condition showed greater improvement in interpersonal problems than patients in the treatment as usual condition. Although this quasi-experimental study has serious limitations, the results may indicate that agoraphobic patients with Cluster C traits should be treated in cognitive agoraphobia and schema-focused programs rather than in psychodynamic treatment as usual programs in order to reduce their level of interpersonal problems.

Effects of Simulation With Problem-Based Learning Program on Metacognition, Team Efficacy, and Learning Attitude in Nursing Students: Nursing Care With Increased Intracranial Pressure Patient.

PubMed

Lee, Myung-Nam; Nam, Kyung-Dong; Kim, Hyeon-Young

2017-03-01

Nursing care for patients with central nervous system problems requires advanced professional knowledge and care skills. Nursing students are more likely to have difficulty in dealing with adult patients who have severe neurological problems in clinical practice. This study investigated the effect on the metacognition, team efficacy, and learning attitude of nursing students after an integrated simulation and problem-based learning program. A real scenario of a patient with increased intracranial pressure was simulated for the students. The results showed that this method was effective in improving the metacognitive ability of the students. Furthermore, we used this comprehensive model of simulation with problem-based learning in order to assess the consequences of student satisfaction with the nursing major, interpersonal relationships, and importance of simulation-based education in relation to the effectiveness of the integrated simulation with problem-based learning. The results can be used to improve the design of clinical practicum and nursing education.

End-of-life education using the dramatic arts: the Wit educational initiative.

PubMed

Lorenz, Karl A; Steckart, M Jillisa; Rosenfeld, Kenneth E

2004-05-01

Caring for dying persons requires skill in interpersonal aspects of care, which may be difficult to teach using conventional educational methods. The Pulitzer Prize-winning play Wit relates the personal story of a patient dying from metastatic ovarian cancer and describes the protagonist's experience with medical care from diagnosis to death. Members of the Department of Medicine at the VA Greater Los Angeles Health care System and the David Geffen School of Medicine, UCLA developed a program that utilized Wit to educate medical students, residents, and staff providers in the humanistic elements of end-of-life care. Between February 2000 and January 2002 the Wit Educational Initiative organized on-site readings of Wit by local professional theatre companies at medical centers throughout the United States and Canada, inviting medical students, housestaff, and other providers to attend the play followed by structured discussions of the play's themes. The Initiative provided extensive support for potential program sites including publicity, providing a handbook with a step-by-step guide to organizing local programs, and feedback of postperformance survey results. The Initiative was successful in organizing performances at 32 out of 54 (59%) medical centers where a local production of Wit was identified. Survey respondents confirmed the appeal, emotional impact, and perceived relevance of drama in end-of-life education. An educational program using theatre to educate trainees in the humanistic aspects of end-of-life care was enthusiastically received by medical schools and rated highly by attendees.

Improving Interpersonal Job Skills by Applying Cross-Cultural Training

ERIC Educational Resources Information Center

Barker, S. A.

2004-01-01

This paper presents an experimental study that examined the effects of cross-cultural instruction on the interpersonal job skills of students in secondary vocational programs. The findings indicated that students receiving the cross-cultural instruction had significantly higher generalizable interpersonal relations skills achievement than students…

Interpersonal violence issues in the nursing classroom.

PubMed

Gagan, Mary Jo

2003-03-01

Interpersonal violence in the United States has been called a health issue of epidemic proportions (Rudman & Alpert, 2000). Reports of interpersonal violence appear daily in popular media, and specific cases have been sensationalized. The nursing profession traditionally has attempted to respond to major health issues through education, political activity, and direct patient care. So, what have nurse educators done to prepare nurses to address this issue in their clinical practices and communities?

Training frontline workforce on psychosis management: a prospective study of training effects.

PubMed

Sørlie, Tore; Borg, Marit; Flage, Karin B; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar B; Benth, Jūratė Šaltytė; Ruud, Torleif

2015-01-01

The care situation for persons experiencing severe mental illness is often complex and demands good coordination, communication, and interpersonal relationships among those involved from the primary and specialized mental health care systems. For 15 years, professional care providers from different service levels within the same geographical areas in Norway have been trained together in a 2-year local onsite training program with the aim of increasing skills, joint understanding, and collaboration in their work with individuals experiencing severe mental illness. The key aspects of competence addressed by the training program were measured at baseline, after 1 year, and at the end of the training period. Professional education and experience were also rated at baseline. Data were collected between 1999 and 2005 and were analyzed by estimating a linear mixed model. Results showed a significant increase in participants' experienced competence in all training goals, especially for the understanding of psychosis and relationship building. There was no significant variance at the program level, indicating consistent implementation of local programs. This prospective study indicates that the training program was successful in increasing perceived competence in the areas addressed, and training staff from different service levels together probably contributed to more collaboration. This training model still operates in Norway.

Cautions: Implementing Interpersonal Interaction in Workplace E-Learning

ERIC Educational Resources Information Center

Githens, Rod P.

2006-01-01

E-learning programs in workplaces have been slow to incorporate social and collaborative methods. Although these programs provide flexibility and cost savings, poor learning outcomes and low completion rates have caused some organizations to transition to approaches that include interpersonal interaction. In reviewing studies of e-learning…

Darfur refugees in Cairo: mental health and interpersonal conflict in the aftermath of genocide.

PubMed

Meffert, Susan M; Marmar, Charles R

2009-11-01

Hundreds of thousands of Darfur people affected by the Sudanese genocide have fled to Cairo, Egypt, in search of assistance. Collaborating with Africa and Middle East Refugee Assistance (AMERA), the authors conducted a mental health care needs assessment among Darfur refugees in Cairo. Information was collected using individual and focus group interviews to identify gaps in mental health care and develop understandings of emotional and relationship problems. The refugee mental health care system has a piecemeal structure with gaps in outpatient services. There is moderate to severe emotional distress among many Darfur refugees, including symptoms of depression and trauma, and interpersonal conflict, both domestic violence and broader community conflict, elevated relative to pregenocide levels. Given the established relationships between symptoms of depression/traumatic stress and interpersonal violence, improving mental health is important for both preventing mental health decompensation and stemming future cycles of intra- and intergroup conflict.

Interpersonal Effects of Suffering in Older Adult Caregiving Relationships

PubMed Central

Monin, Joan K.; Schulz, Richard

2009-01-01

Examining the interpersonal effects of suffering in the context of family caregiving is an important step to a broader understanding of how exposure to suffering affects humans. In this review article, we first describe existing evidence that being exposed to the suffering of a care recipient (conceptualized as psychological distress, physical symptoms, and existential/spiritual distress) directly influences caregivers’ emotional experiences. Drawing from past theory and research, we propose that caregivers experience similar, complementary, and/or defensive emotions in response to care recipient suffering through mechanisms such as cognitive empathy, mimicry, and conditioned learning, placing caregivers at risk for psychological and physical morbidity. We then describe how gender, relationship closeness, caregiving efficacy, and individual differences in emotion regulation moderate these processes. Finally, we provide directions for future research to deepen our understanding of interpersonal phenomena among older adults, and we discuss implications for clinical interventions to alleviate the suffering of both caregivers and care recipients. PMID:19739924

The characteristics of medical students' personality types and interpersonal needs.

PubMed

Hur, Yera; Cho, A-Ra; Kim, Sun

2013-12-01

Medical students' personality types and interpersonal needs must be considered. The purpose of this study was to examine the characteristics of personality types and interpersonal needs. A total of 171 students in Konyang University College of Medicine were examined using the Myers-Briggs Type Indicator (MBTI) and Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B). The data were analyzed by frequency analysis, t-test, and one-sample proportion test. The proportion of the 4 pairs of MBTI dimensions were Extroversion (E)-Introversion (I) (53.2% vs. 46.8%), Sensing (S)-Intuition (N) (63.2% vs. 36.8%), Thinking (T)-Feeling (F) (59.7% vs. 40.4%), and Judging (J)-Perceiving (P) (56.1% vs. 43.9%). The predominant personality types were ISTJ (16.4%), ESTJ (14.0%), and ESFJ (10.5%). The level of interpersonal needs were medium rage that was inclusion (mean=8.1), control (mean=8.8), affection (mean=8.1), expressed behavior (mean=12.1), wanted behavior (mean=12.9), and overall interpersonal needs (mean=25.0). Of the basic social needs, males and females differed significantly with regard to control needs (p=0.028). Educational programs that take into account personality types and characteristics of interpersonal needs are crucial in providing effective medical education. Our results suggest that the characteristics of personality types and interpersonal needs should be considered in developing an interpersonal relations improvement program for medical students.

Parental overprotection increases interpersonal sensitivity in healthy subjects.

PubMed

Otani, Koichi; Suzuki, Akihito; Matsumoto, Yoshihiko; Kamata, Mitsuhiro

2009-01-01

The effect of parental rearing on interpersonal sensitivity was studied in 469 Japanese volunteers. Perceived parental rearing was assessed by the Parental Bonding Instrument, which consists of the factors of care and protection, and interpersonal sensitivity was measured by the Interpersonal Sensitivity Measure (IPSM). In male subjects, higher IPSM scores were related to higher scores of paternal protection (P < .01) and maternal protection (P < .05). In female subjects, higher IPSM scores were related to higher scores of maternal protection (P < .001). The present study suggests that in both males and females, interpersonal sensitivity is increased by high protection of the same-sex parents and that in males there is an additional effect of high maternal protection.

[Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia].

PubMed

Kim, Jinhee; Na, Hyunjoo

2017-10-01

Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia. The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis. Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant. The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia. © 2017 Korean Society of Nursing Science

Disease management interventions: what's in the black box?

PubMed

Linden, Ariel; Roberts, Nancy

2004-01-01

In discussing evaluation techniques to assess disease management (DM) program outcomes, it is often assumed that DM program interventions are premised on sound clinical judgment, an understanding of the disease process, and knowledge of the psychosocial models of behavioral change that must be used to effect those processes and ultimately improve the health outcomes that are being evaluated. This paper describes eight commonly used behavioral change models applied in the healthcare industry today. They represent programs designed to address individual, interpersonal, and community level factors as well as "packaged" comprehensive approaches. These models illustrate the breadth of approaches to consider when designing or assessing DM program interventions. Careful consideration of the type of behavioral change desired and the theories of how to effect such change should be an integral part of designing disease management program interventions.

The high cost of conflict.

PubMed

Forté, P S

1997-01-01

Conflict is inevitable, especially in highly stressed environments. Clinical environments marked by nurse-physician conflict (and nurse withdrawal related to conflict avoidance) have been proven to be counterproductive to patients. Clinical environments with nurse-physician professional collegiality and respectful communication show decreased patient morbidity and mortality, thus enhancing outcomes. The growth of managed care, and the organizational turmoil associated with rapid change, makes it imperative to structure the health care environment so that conflict can be dealt with in a safe and healthy manner. Professional health care education programs and employers have a responsibility to provide interactive opportunities for multidisciplinary audiences through which conflict management skills can be learned and truly change the interpersonal environment. Professionals must be free to focus their energy on the needs of the patient, not on staff difficulties.

Improving Empathy in the Prevention of Sexual Abuse Against Children and Youngsters.

PubMed

Man-Ging, Carlos Ignacio; Böhm, Bettina; Fuchs, Katharina Anna; Witte, Susanne; Frick, Eckhard

2015-01-01

The aim of this research is to study the improvement of empathy in child-care professionals (i.e., teachers, psychologists, social workers) involved in the prevention of sexual abuse against children and youngsters. An E-Learning training pilot program was conducted with pre- and post-measures (T(1) = at the beginning and T(2) = after 6 months) using the program's standardized questionnaires of Situational Empathy and the Interpersonal Reactivity Index (IRI) as a Dispositional Empathy measure. A sample of 42 experienced professionals involved in activities with children and youngsters was obtained from the International Movement of Popular Education in Latin America called "Fe y Alegría." Significant progress was found in the scales of Situational Empathy and in some Coping subscales. The final outcomes seem to indicate that the prevention program elicits important changes in the cognitive sphere and that these changes are more intense when the implication level for the situation is greater. This research shows that empathy can be improved through professional experience and careful situational involvement.

Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

PubMed

Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

2018-04-12

AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences successful primary care and public health collaboration at these levels and are important considerations in building and sustaining primary care and public health collaborations.

Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

ERIC Educational Resources Information Center

Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

2006-01-01

Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

Anger Management Program Participants Gain Behavioral Changes in Interpersonal Relationships

ERIC Educational Resources Information Center

Pish, Suzanne; Clark-Jones, Teresa; Eschbach, Cheryl; Tiret, Holly

2016-01-01

RELAX: Alternatives to Anger is an educational anger management program that helps adults understand and manage anger, develop communication skills, manage stress, and make positive behavioral changes in their interpersonal relationships. A sample of 1,168 evaluation surveys were collected from RELAX: Alternatives to Anger participants over 3…

An Evaluation of Program M in Rio De Janeiro, Brazil: An Analysis of Change in Self-Efficacy in Interpersonal Relationships, Gender Equity, and Self-Reported Risky Behaviors among Women in Two Low-Income Communities

ERIC Educational Resources Information Center

Rocha, Valeria

2011-01-01

This quantitative study examined whether Program M, an intervention targeting young women in a low-income community in the city of Rio de Janeiro, Brazil, promoted changes in gender equitable attitudes and self-efficacy in interpersonal relationships among program participants. Further, it investigated whether the program influenced these young…

E-health in graduate and postgraduate medical education: illusions, expectations and reality.

PubMed

Bari, Ferenc; Forczek, Erzsébet; Hantos, Zoltán

2011-01-01

With the overall growth of informatics, the medical education system should also provide programs at both graduate and post-graduate levels. While there is a wide consensus as to the importance of this urgent need, several factors slow down the construction and operation of effective education programs in medical and nursing schools. The increasing need for better and more comprehensive training in informatics is strongly limited by several factors including undefined output skills, tight time frame etc. An efficient development of partnerships within the health care system assumes that all professionals involved must possess strong informatics and interpersonal knowledge, and skills reaching beyond their own individual fields. There is an emerging need to define the basic skills and knowledge for each level of the health care education. Trans-border cooperation offers a unique opportunity for the establishment of common criteria for basic skills and knowledge, via joint discussions, collaborative thinking and concerted action.

Interpersonal Dynamics and Organizational Change in Religious Communities.

ERIC Educational Resources Information Center

Barber, William H.; Rock, Leo P.

This paper discusses the organizational structure of religious communities and its effect on interpersonal relations. Religious communities tend to be organized structurally according to the traditional bureaucratic model of (1) relatively rigid structure; (2) carefully defined functional specialization; (3) direction and control implemented…

TU-CD-213-00: Administrative Aspects of Medical Physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas suchmore » as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.« less

TU-CD-213-01: Communication, Negotiation, and Persuasion: Approaches for Better Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, J.

As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas suchmore » as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.« less

TU-CD-213-03: Communication, Negotiation, and Persuasion: Approaches for Better Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wells, M.

As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas suchmore » as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.« less

TU-CD-213-04: Panel Discussion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, J.

As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas suchmore » as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.« less

TU-CD-213-02: Communication, Negotiation, and Persuasion: Approaches for Better Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clements, J.

As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas suchmore » as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.« less

Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

PubMed

Lee King, Patricia A; Duan, Lei; Amaro, Hortensia

2015-01-01

We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.

Transition to surgical residency: a multi-institutional study of perceived intern preparedness and the effect of a formal residency preparatory course in the fourth year of medical school.

PubMed

Minter, Rebecca M; Amos, Keith D; Bentz, Michael L; Blair, Patrice Gabler; Brandt, Christopher; D'Cunha, Jonathan; Davis, Elisabeth; Delman, Keith A; Deutsch, Ellen S; Divino, Celia; Kingsley, Darra; Klingensmith, Mary; Meterissian, Sarkis; Sachdeva, Ajit K; Terhune, Kyla; Termuhlen, Paula M; Mullan, Patricia B

2015-08-01

To evaluate interns' perceived preparedness for defined surgical residency responsibilities and to determine whether fourth-year medical school (M4) preparatory courses ("bootcamps") facilitate transition to internship. The authors conducted a multi-institutional, mixed-methods study (June 2009) evaluating interns from 11 U.S. and Canadian surgery residency programs. Interns completed structured surveys and answered open-ended reflective questions about their preparedness for their surgery internship. Analyses include t tests comparing ratings of interns who had and had not participated in formal internship preparation programs. The authors calculated Cohen d for effect size and used grounded theory to identify themes in the interns' reflections. Of 221 eligible interns, 158 (71.5%) participated. Interns self-reported only moderate preparation for most defined care responsibilities in the medical knowledge and patient care domains but, overall, felt well prepared in the professionalism, interpersonal communication, practice-based learning, and systems-based practice domains. Interns who participated in M4 preparatory curricula had higher self-assessed ratings of surgical technical skills, professionalism, interpersonal communication skills, and overall preparation, at statistically significant levels (P < .05) with medium effect sizes. Themes identified in interns' characterizations of their greatest internship challenges included anxiety or lack of preparation related to performance of technical skills or procedures, managing simultaneous demands, being first responders for critically ill patients, clinical management of predictable postoperative conditions, and difficult communications. Entering surgical residency, interns report not feeling prepared to fulfill common clinical and professional responsibilities. As M4 curricula may enhance preparation, programs facilitating transition to residency should be developed and evaluated.

Interpersonal Skills in MBA Admissions: How Are They Conceptualized and Assessed?

ERIC Educational Resources Information Center

Beenen, Gerard; Pichler, Shaun; Davoudpour, Shahin

2018-01-01

Employers and students concur that soft skills or interpersonal skills are critical to managerial success, yet we know little about how MBA program admissions professionals conceptualize and assess these skills in the context of global management education. Such practices have key implications for interpersonal skills curriculum and training in…

Foundations of the Self Awareness and Interpersonal Communication Workshop.

ERIC Educational Resources Information Center

Keltner, John W.

A review of the history and development of experiential learning in its educational and therapeutic contexts emphasizes the value of self-awareness as a prerequisite to interpersonal and group development. It also serves to underscore the potential of the Self Awareness and Interpersonal Communication (SAIC) program in an American society with…

Examining Interpersonal Dynamics among Adult Learners through the Lens of Place

ERIC Educational Resources Information Center

Prins, Esther

2009-01-01

The purpose of this article is to analyze interpersonal problems among adult learners in three family literacy programs and to identify how these tensions were connected to place or distinctive community contexts. Drawing on the critical geography literature, the article argues that interpersonal problems must be understood in light of…

Perspectives on Inmate Communication and Interpersonal Relations in the Maximum Security Prison.

ERIC Educational Resources Information Center

Van Voorhis, Patricia; Meussling, Vonne

In recent years, scholarly and applied inquiry has addressed the importance of interpersonal communication patterns and problems in maximum security institutions for males. As a result of this research, the number of programs designed to improve the interpersonal effectiveness of prison inmates has increased dramatically. Research suggests that…

[Gender perspective in health care teaching: a pending task].

PubMed

Arcos, Estela; Poblete, Johanna; Molina Vega, Irma; Miranda, Christian; Zúñiga, Yanira; Fecci, Ester; Rodríguez, Laura; Márquez, Myriam; Ramírez, Miguel

2007-06-01

Gender must be considered in the design and implementation of health policies to safeguard equity and accomplish sanitary objectives. To identify gender perspective in the curricula of five health care careers in the Universidad Austral de Chile. To identify the situation of women in the teaching profile of such curricula. An exploratory and descriptive study with a critical reading of the structure of the programs of 217 courses. Revision of official academic registries. Gender is usually not included in the curricula of health care careers. The generic language conceals female academics and students. There was a scarce inclusion of cross sectional issues such as collaborative work, interpersonal and democratic relationship, equity and critical analysis. There were no differences in academic achievements between female and male students. The contractual profile of female academics reproduces the gender inequity of the work market. The inclusion of gender is a pending task in the training of health care professionals.

Community Palliative Care Nurses' Challenges and Coping Strategies on Delivering Home-Based Pediatric Palliative Care.

PubMed

Chong, LeeAi; Abdullah, Adina

2017-03-01

The aim of this study was to explore the experience of community palliative care nurses providing home care to children. A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports. These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.

Coping strategies for HIV-related stigma in Liuzhou, China.

PubMed

Zhang, Ying-Xia; Ying-Xia, Zhang; Golin, Carol E; Bu, Jin; Jin, Bu; Emrick, Catherine Boland; Nan, Zhang; Li, Ming-Qiang; Ming-Qiang, Li

2014-02-01

This study explores the feelings, experiences, and coping strategies of people living with HIV (PLHIV) in Liuzhou, China. In a southwestern Chinese city with high HIV prevalence, we conducted semi-structured in-depth interviews with 47 PLHIV selected to represent individuals who had acquired HIV via different acquisition routes. Many participants felt severely stigmatized; they commonly reported having very low self-esteem and feelings of despair. Based on style of coping and whether it occurred at the interpersonal or intrapersonal level, four types of coping that participants used to deal with HIV-associated stigma were identified: (1) Compassion (Passive/Avoidant-Interpersonal); (2) Hiding HIV status (Passive/Avoidant-Intrapersonal); (3) Social support (Active/Problem-focused-Interpersonal; and (4) Self-care (Active/Problem-focused-Intrapersonal). Educational and stigma-reduction interventions targeting potential social support networks for PLHIV (e.g., family, close friends, and peers) could strengthen active interpersonal PLHIV coping strategies. Interventions teaching self-care to PLHIV would encourage active intrapersonal coping, both of which may enhance PLHIV quality of life in Liuzhou, China.

Interpersonal Influence Field Test, Impact Study and Expert Review. Improving Teaching Competencies Program.

ERIC Educational Resources Information Center

Hiscox, Suzanne B.; And Others

This report focuses on Interpersonal Influence (INF), an instructional system developed by the Improving Teaching Competencies Program at the Northwest Regional Educational Laboratory. The stated purpose of the system is to provide classroom teachers with a set of skills and concepts that can help them engage in productive, collaborative efforts…

Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa

PubMed Central

Mabuto, Tonderai; Charalambous, Salome

2017-01-01

Background: Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement. Methods: We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa. The counseling arm was selected because it increased verified entry into care by 40% compared with the standard of care. We used thematic analysis to identify key aspects of communication directed specifically toward a client's goals or concerns. Results: Of the participants, 18 of 28 were female and 21 entered HIV care within 90 days of diagnosis. Initiating a communication around client-perceived consequences of HIV was at times effective. However, counselors also probed around general topics of life disruption—such as potential for child bearing—as a technique to direct the conversation toward the participant's needs. Once individual concerns and needs were identified, counselors tried to introduce clinical care seeking and collaboratively discuss potential barriers and approaches to overcome to accessing that care. Conclusions: Through the use of interpersonal communication messages were focused on immediate needs and concerns of the client. When effectively delivered, it may be an important communication approach to improve care engagement. PMID:27930608

Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa.

PubMed

Mabuto, Tonderai; Charalambous, Salome; Hoffmann, Christopher J

2017-01-01

Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement. We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa. The counseling arm was selected because it increased verified entry into care by 40% compared with the standard of care. We used thematic analysis to identify key aspects of communication directed specifically toward a client's goals or concerns. Of the participants, 18 of 28 were female and 21 entered HIV care within 90 days of diagnosis. Initiating a communication around client-perceived consequences of HIV was at times effective. However, counselors also probed around general topics of life disruption-such as potential for child bearing-as a technique to direct the conversation toward the participant's needs. Once individual concerns and needs were identified, counselors tried to introduce clinical care seeking and collaboratively discuss potential barriers and approaches to overcome to accessing that care. Through the use of interpersonal communication messages were focused on immediate needs and concerns of the client. When effectively delivered, it may be an important communication approach to improve care engagement.

Physicians and Students Take to the Streets to Ask: What Do People Want From Their Health Care?

PubMed

DiGioia, Kimberly; Nair, Mohit; Shields, Morgan; Saini, Vikas

2018-06-01

With the aim of better understanding what the public (as opposed to "patients") wants from health care, this study asked people on the street, "What does the right health care mean to you?" Responses ranged from "Caring about me more than just in the appointment" to "That everyone should see exactly what medical treatment costs." A qualitative analysis revealed that all responses fell into 2 overarching categories: health care at the interpersonal level and health care at the system level. Approximately 66.7% of responses included system-level factors, whereas 59% of responses included interpersonal-level factors. We conclude that the public is cognizant of and concerned about issues that also concern patients and others working to improve health care and, thus, should be engaged in the process to design care in a way that meets their needs and preferences before they become ill or interact with the delivery system.

Promoting young children's interpersonal safety knowledge, intentions, confidence, and protective behavior skills: Outcomes of a randomized controlled trial.

PubMed

White, Codi; Shanley, Dianne C; Zimmer-Gembeck, Melanie J; Walsh, Kerryann; Hawkins, Russell; Lines, Katrina; Webb, Haley

2018-06-11

Promoting young children's interpersonal safety knowledge, intentions confidence and skills is the goal of many child maltreatment prevention programs; however, evaluation of their effectiveness has been limited. In this study, a randomized controlled trial was conducted examining the effectiveness of the Australian protective behaviors program, Learn to be safe with Emmy and friends™ compared to a waitlist condition. In total, 611 Australian children in Grade 1 (5-7 years; 50% male) participated, with assessments at Pre-intervention, Post-intervention and a 6-month follow-up. This study also included a novel assessment of interpersonal safety skills through the Observed Protective Behaviors Test (OPBT). Analyses showed participating in Learn to be safe with Emmy and friends™ was effective post-program in improving interpersonal safety knowledge (child and parent-rated) and parent-rated interpersonal safety skills. These benefits were retained at the 6-month follow-up, with participating children also reporting increased disclosure confidence. However, Learn to be safe with Emmy and friends™ participation did not significantly impact children's disclosure intentions, safety identification skills, or interpersonal safety skills as measured by the OPBT. Future research may seek to evaluate the effect of further parent and teacher integration into training methods and increased use of behavioral rehearsal and modelling to more effectively target specific disclosure intentions and skills. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of a chronic kidney disease patient navigator program.

PubMed

Jolly, Stacey E; Navaneethan, Sankar D; Schold, Jesse D; Arrigain, Susana; Konig, Victoria; Burrucker, Yvette K; Hyland, Jennifer; Dann, Priscilla; Tucky, Barbara H; Sharp, John W; Nally, Joseph V

2015-05-03

Chronic Kidney Disease (CKD) is a public health problem and there is a scarcity of type 2 CKD translational research that incorporates educational tools. Patient navigators have been shown to be effective at reducing disparities and improving outcomes in the oncology field. We describe the creation of a CKD Patient Navigator program designed to help coordinate care, address system-barriers, and educate/motivate patients. The conceptual framework for the CKD Patient Navigator Program is rooted in the Chronic Care Model that has a main goal of high-quality chronic disease management. Our established multidisciplinary CKD research team enlisted new members from information technology and data management to help create the program. It encompassed three phases: hiring, training, and implementation. For hiring, we wanted a non-medical or lay person with a college degree that possessed strong interpersonal skills and experience in a service-orientated field. For training, there were three key areas: general patient navigator training, CKD education, and electronic health record (EHR) training. For implementation, we defined barriers of care and created EHR templates for which pertinent study data could be extracted. We have hired two CKD patient navigators who will be responsible for navigating CKD patients enrolled in a clinical trial. They have undergone training in general patient navigation, specific CKD education through directed readings and clinical shadowing, as well as EHR and other patient related privacy and research training. The need for novel approaches like our CKD patient navigator program designed to impact CKD care is vital and should utilize team-based care and health information technology given the changing landscape of our health systems.

Testing a healthcare provider-patient communicative relationship quality model of pharmaceutical care in hospitals.

PubMed

Wang, Dan; Liu, Chenxi; Zhang, Zinan; Ye, Liping; Zhang, Xinping

2018-06-01

Background Patient-centeredness and participatory care is increasingly regarded as a proxy for high-quality interpersonal care. Considering the development of patient-centeredness and participatory care relationship model in pharmacist-patient domain, it is of great significance to explore the mechanism of how pharmacist and patient participative behaviors influence relationship quality and patient outcomes. Objective To validate pharmacist-patient relationship quality model in Chinese hospitals. Four tertiary hospitals in 2017. Methods The provision of pharmaceutical care was investigated. A cross-sectional questionnaire survey covering different constructs of communicative relationship quality model was conducted and the associations among pairs of the study constructs were explored. Based on the results of confirmatory factor analysis, path analysis was conducted to validate the proposed communicative relationship quality model. Main outcome measure Model fit indicators including Tucker-Lewis index (TLI), comparative fit index (CFI), root mean square error of approximation (RMSEA) and weighted root mean square residual(WRMR). Results There were 589 patients included in our study. The final path model had an excellent fit (TLI = 0.98, CFI = 0.98, RMSEA = 0.05; WRMR = 1.06). HCP participative behavior/patient-centeredness (β = 0.79, p < 0.001) and interpersonal communication (β = 0.13, p < 0.001) directly impact the communicative relationship quality. But patient participative behavior was not a predictor of either communicative relationship quality or patient satisfaction. Conclusion HCP participative behavior/patient-centeredness and interpersonal communication are positively related to relationship quality, and relationship quality is mediator between HCP participative behavior and interpersonal communication with patient satisfaction.

The employee retention triad in health care: Exploring relationships amongst organisational justice, affective commitment and turnover intention.

PubMed

Perreira, Tyrone A; Berta, Whitney; Herbert, Monique

2018-04-01

To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care. Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis. The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention. The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees. Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing. © 2018 John Wiley & Sons Ltd.

Birds of a feather stay active together: a case study of an all-male older adult exercise program.

PubMed

Dunlop, William L; Beauchamp, Mark R

2013-04-01

In this article, the authors report the results of a case study examining a group-based exercise program for older adult men. The purpose of the investigation was to identify the elements of this program responsible for its appeal. Interviews, conducted with a purposely sampled subset of program members, were subject to content-analytic procedures. Participants identified social connectedness (reflected by themes of demographic homogeneity, support and care, customs and traditions, and interpersonal comparisons) and supportive leadership behaviors (constituted by communication, the provision of choice, and individualized attention) as major attractions in the program. A few participants also noted the challenge that exists when a program is seen by some as being a social program that provides opportunities for exercise and by others as an exercise program that provides opportunities for socializing. Findings are discussed in relation to contextual factors associated with older adult men's involvement in physical activity programs.

Psychological Strategies for Resolving Interpersonal Conflicts among Administrators in Tertiary Institutions: A Case of Nnamdi Azikiwe University Awka, Nigeria

ERIC Educational Resources Information Center

Obi, Joy Sylvia C.; Obineli, Amaka S.

2015-01-01

The study was aimed at studying the psychological strategies for resolving interpersonal conflict among administrators in Tertiary Institutions with Nnamdi Azikiwe University as the case study. Gaining an understanding of these strategies may assist administrators of educational programs in handling interpersonal conflicts in more constructive and…

Exploring the Relevance of Interpersonal Dependency as a Treatment Issue in Batterer Intervention

ERIC Educational Resources Information Center

Carney, Michelle Mohr; Buttell, Fred

2006-01-01

Objective: The purpose of the study was to (a) investigate the pretreatment levels of interpersonal dependency and violence among men entering a 16-week, court-mandated, batterer intervention program (BIP) and determine if there were any associations between interpersonal dependency and violence and (b) evaluate the treatment effect of a standard…

Effects of a Play-Based Teacher Consultation (PBTC) Program on Interpersonal Skills of Elementary School Teachers in the Classroom

ERIC Educational Resources Information Center

Carlson, Sarah E.

2011-01-01

The purpose of this study was to examine the effectiveness of a play-based teacher consultation (PBTC) program on individual teachers' interpersonal classroom behaviors and teacher-child relationships. The research questions addressed the application of child-centered play therapy principles and PBTC increasing teacher responsiveness, decreasing…

Negotiating futility, managing emotions: nursing the transition to palliative care.

PubMed

Broom, Alex; Kirby, Emma; Good, Phillip; Wootton, Julia; Yates, Patsy; Hardy, Janet

2015-03-01

Nurses play a pivotal role in caring for patients during the transition from life-prolonging care to palliative care. This is an area of nursing prone to emotional difficulty, interpersonal complexity, and interprofessional conflict. It is situated within complex social dynamics, including those related to establishing and accepting futility and reconciling the desire to maintain hope. Here, drawing on interviews with 20 Australian nurses, we unpack their accounts of nursing the transition to palliative care, focusing on the purpose of nursing at the point of transition; accounts of communication and strategies for representing palliative care; emotional engagement and burden; and key interprofessional challenges. We argue that in caring for patients approaching the end of life, nurses occupy precarious interpersonal and interprofessional spaces that involve a negotiated order around sentimental work, providing them with both capital (privileged access) and burden (emotional suffering) within their day-to-day work. © The Author(s) 2014.

Upgrade and interpersonal skills training at American Airlines

NASA Technical Reports Server (NTRS)

Estridge, W. W.; Mansfield, J. L.

1980-01-01

Segments of the interpersonal skills training audio visual program are presented. The program was developed to train customer contact personnel with specific emphasis on transactional analysis in customer treatment. Concepts of transactional analysis are summarized in terms of the make up of the personality, identified as the three ego states. These ego states are identified as the parent, the adult, and the child. Synopses of four of the tape programs are given.

The influence of interpersonal relationships on nurse managers' work engagement and proactive work behavior.

PubMed

Warshawsky, Nora E; Havens, Donna S; Knafl, George

2012-09-01

This study tested the effects of interpersonal relationships on nurse managers' work engagement and proactive work behavior. An engaged workforce may help healthcare organizations improve performance. In healthcare, nurse managers are responsible for creating motivating work environments. They also need to be engaged, yet little is known about what influences nurse managers' performance. A self-administered electronic survey was used to collect data from 323 nurse managers working in acute care hospitals. Instruments included the Relational Coordination Scale, Utrecht Work Engagement Scale, and Proactive Work Behavior Scale. Interpersonal relationships with nurse administrators were most predictive of nurse managers' work engagement. Interpersonal relationships with physicians were most predictive of nurse managers' proactive work behavior. Organizational cultures that foster quality interpersonal relationships will support the job performance of nurse managers.

'But doctor, someone has to do something': resolving interpersonal conflicts in the workplace.

PubMed

Robinett, J; Cruser, A; Podawiltz, A L

1995-05-01

Physicians are often called on to address interpersonal conflicts among office staff and colleagues. Because such strife can interfere with patient care, physicians should learn to diffuse these situations as adeptly and quickly as possible. The authors outline one approach, which they developed while working at the Oklahoma Department of Mental Health. Designated by the mnemonic LIFT (Listen, Inquire, ask for Feedback, Test), this approach has been used successfully to resolve interpersonal conflict in small groups.

Willingness to express emotions to caregiving spouses.

PubMed

Monin, Joan K; Martire, Lynn M; Schulz, Richard; Clark, Margaret S

2009-02-01

This study examined the association between care-recipients' willingness to express emotions to spousal caregivers and caregiver's well-being and support behaviors. Using self-report measures in the context of a larger study, 262 care-recipients with osteoarthritis reported on their willingness to express emotions to caregivers, and caregivers reported on their stress and insensitive responding to care-recipients. Results revealed that care-recipients' willingness to express happiness was associated with less insensitive caregiver responding, and willingness to express interpersonal emotions (e.g., compassion, guilt) was associated with less caregiving stress. There were also gender differences, such that caregiving wives, in particular, benefited from their husband's willingness to express vulnerable (e.g., anxiety, sadness) and interpersonal emotions. (c) 2009 APA, all rights reserved

Willingness to Express Emotions to Caregiving Spouses

PubMed Central

Monin, Joan K.; Martire, Lynn M.; Schulz, Richard; Clark, Margaret S.

2009-01-01

This study examined the association between care-recipients’ willingness to express emotions to spousal caregivers and caregiver’s well-being and support behaviors. Using self-report measures in the context of a larger study, 262 care-recipients with osteoarthritis reported on their willingness to express emotions to caregivers, and caregivers reported on their stress and insensitive responding to care-recipients. Results revealed that care-recipients’ willingness to express happiness was associated with less insensitive caregiver responding, and willingness to express interpersonal emotions (e.g., compassion, guilt) was associated with less caregiving stress. There were also gender differences, such that caregiving wives, in particular, benefited from their husband’s willingness to express vulnerable (e.g., anxiety, sadness) and interpersonal emotions. PMID:19186921

Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study.

PubMed

Ustjanauskas, Amy E; Quinn, Gwendolyn P; Pan, Tonya M; Rivera, Maria; Vázquez-Otero, Coralia; Ung, Danielle; Roetzheim, Richard G; Laronga, Christine; Johnson, Kenneth; Norton, Marilyn; Carrizosa, Claudia; Muñoz, Dariana; Goldenstein, Marissa; Nuhaily, Sumayah; Wells, Kristen J

2017-12-01

Research investigating facilitators of survivorship care among underserved breast cancer survivors (BCS) is sparse. This study aimed to explore facilitators of survivorship care among underserved BCS within the first 5 years following chemotherapy, radiation, or surgery for breast cancer. In-depth interviews were conducted, using a semi-structured interview guide, with underserved BCS exploring survivorship care experiences. Content analysis of the verbatim transcripts was applied, and results were summarized according to themes related to facilitators of breast cancer survivorship care. Interviews were conducted with 25 BCS. Eight main themes were identified: coordination of care; positive perceptions of health care providers; communication between patient and health care providers; financial and insurance facilitators; information, classes, and programs provided; assistance provided by organizations and health care professionals; transportation facilitators; and job flexibility. This study provides a comprehensive look at facilitators of survivorship care among underserved BCS. BCS endorsed several facilitators of their survivorship care, mainly at the interpersonal, organizational, and societal level. This study adds to the research literature on catalysts of care among underserved BCS. Results from this study are currently being used to inform a patient navigation intervention to facilitate care among this population.

Violence in the United States

PubMed Central

Sumner, Steven A.; Mercy, James A.; Dahlberg, Linda L.; Hillis, Susan D.; Klevens, Joanne; Houry, Debra

2015-01-01

IMPORTANCE Interpersonal violence, which includes child abuse and neglect, youth violence, intimate partner violence, sexual violence, and elder abuse, affects millions of US residents each year. However, surveillance systems, programs, and policies to address violence often lack broad, cross-sector collaboration, and there is limited awareness of effective strategies to prevent violence. OBJECTIVES To describe the burden of interpersonal violence in the United States, explore challenges to violence prevention efforts and to identify prevention opportunities. DATA SOURCES We reviewed data from health and law enforcement surveillance systems including the National Vital Statistics System, the Federal Bureau of Investigation’s Uniform Crime Reports, the US Justice Department’s National Crime Victimization Survey, the National Survey of Children’s Exposure to Violence, the National Child Abuse and Neglect Data System, the National Intimate Partner and Sexual Violence Survey, the Youth Risk Behavior Surveillance System, and the National Electronic Injury Surveillance System—All Injury Program. RESULTS Homicide rates have decreased from a peak of 10.7 per 100 000 persons in 1980 to 5.1 per 100 000 in 2013. Aggravated assault rates have decreased from a peak of 442 per 100 000 in 1992 to 242 per 100 000 in 2012. Nevertheless, annually, there are more than 16 000 homicides and 1.6 million nonfatal assault injuries requiring treatment in emergency departments. More than 12 million adults experience intimate partner violence annually and more than 10 million children younger than 18 years experience some form of maltreatment from a caregiver, ranging from neglect to sexual abuse, but only a small percentage of these violent incidents are reported to law enforcement, health care clinicians, or child protective agencies. Moreover, exposure to violence increases vulnerability to a broad range of mental and physical health problems over the life course; for example, meta-analyses indicate that exposure to physical abuse in childhood is associated with a 54% increased odds of depressive disorder, a 78% increased odds of sexually transmitted illness or risky sexual behavior, and a 32% increased odds of obesity. Rates of violence vary by age, geographic location, sex, and race/ethnicity, and significant disparities exist. Homicide is the leading cause of death for non-Hispanic blacks from age 1 through 44 years, whereas it is the fifth most common cause of death among non-Hispanic whites in this age range. Additionally, efforts to understand, prevent, and respond to interpersonal violence have often neglected the degree to which many forms of violence are interconnected at the individual level, across relationships and communities, and even intergenerationally. The most effective violence prevention strategies include parent and family-focused programs, early childhood education, school-based programs, therapeutic or counseling interventions, and public policy. For example, a systematic review of early childhood home visitation programs found a 38.9% reduction in episodes of child maltreatment in intervention participants compared with control participants. CONCLUSIONS AND RELEVANCE Progress has been made in reducing US rates of interpersonal violence even though a significant burden remains. Multiple strategies exist to improve violence prevention efforts, and health care providers are an important part of this solution. PMID:26241599

Violence in the United States: Status, Challenges, and Opportunities.

PubMed

Sumner, Steven A; Mercy, James A; Dahlberg, Linda L; Hillis, Susan D; Klevens, Joanne; Houry, Debra

2015-08-04

Interpersonal violence, which includes child abuse and neglect, youth violence, intimate partner violence, sexual violence, and elder abuse, affects millions of US residents each year. However, surveillance systems, programs, and policies to address violence often lack broad, cross-sector collaboration, and there is limited awareness of effective strategies to prevent violence. To describe the burden of interpersonal violence in the United States, explore challenges to violence prevention efforts and to identify prevention opportunities. We reviewed data from health and law enforcement surveillance systems including the National Vital Statistics System, the Federal Bureau of Investigation's Uniform Crime Reports, the US Justice Department's National Crime Victimization Survey, the National Survey of Children's Exposure to Violence, the National Child Abuse and Neglect Data System, the National Intimate Partner and Sexual Violence Survey, the Youth Risk Behavior Surveillance System, and the National Electronic Injury Surveillance System-All Injury Program. Homicide rates have decreased from a peak of 10.7 per 100,000 persons in 1980 to 5.1 per 100,000 in 2013. Aggravated assault rates have decreased from a peak of 442 per 100,000 in 1992 to 242 per 100,000 in 2012. Nevertheless, annually, there are more than 16,000 homicides and 1.6 million nonfatal assault injuries requiring treatment in emergency departments. More than 12 million adults experience intimate partner violence annually and more than 10 million children younger than 18 years experience some form of maltreatment from a caregiver, ranging from neglect to sexual abuse, but only a small percentage of these violent incidents are reported to law enforcement, health care clinicians, or child protective agencies. Moreover, exposure to violence increases vulnerability to a broad range of mental and physical health problems over the life course; for example, meta-analyses indicate that exposure to physical abuse in childhood is associated with a 54% increased odds of depressive disorder, a 78% increased odds of sexually transmitted illness or risky sexual behavior, and a 32% increased odds of obesity. Rates of violence vary by age, geographic location, sex, and race/ethnicity, and significant disparities exist. Homicide is the leading cause of death for non-Hispanic blacks from age 1 through 44 years, whereas it is the fifth most common cause of death among non-Hispanic whites in this age range. Additionally, efforts to understand, prevent, and respond to interpersonal violence have often neglected the degree to which many forms of violence are interconnected at the individual level, across relationships and communities, and even intergenerationally. The most effective violence prevention strategies include parent and family-focused programs, early childhood education, school-based programs, therapeutic or counseling interventions, and public policy. For example, a systematic review of early childhood home visitation programs found a 38.9% reduction in episodes of child maltreatment in intervention participants compared with control participants. Progress has been made in reducing US rates of interpersonal violence even though a significant burden remains. Multiple strategies exist to improve violence prevention efforts, and health care providers are an important part of this solution.

An Interprofessional Approach to Exploring the Social Determinants of Health with Dental Hygiene Students.

PubMed

Lapidos, Adrienne; Gwozdek, Anne

2016-01-01

The University of Michigan (U-M) Dental Hygiene Program collaborated with the U-M School of Social Work in developing a course entitled "Skills for Patient- and Family-Centered Care with Diverse Populations." Drawing upon disciplines including dentistry, social work, psychology, and sociology, this course transformed mandatory outreach rotations in safety-net dental settings from a freestanding senior-year experience to an integrated part of the dental hygiene curriculum. The course provided a space in which to discuss the interpersonal aspects of patient care, particularly those related to the social determinants of health. Among the students, a broad range of emotions, frustrations, and hopes were evident, suggesting that there is a need for forums through which students can connect their affective experiences to their practice of patient-centered care. While the course was designed for bachelor's level dental hygiene students, the content and process presented in this paper may be of interest to faculty housed within any allied health professional program, because core themes such as social justice, service-learning, and self-reflection transcend all health professions.

A systematic and comprehensive approach to teaching and evaluating interpersonal skills.

PubMed

Grayson, M; Nugent, C; Oken, S L

1977-11-01

This study addressed one problem with current methods for teaching and evaluating interpersonal skills: the failure to include a wide range of behaviors reported in the literature as contributing to patient dissatisfaction and noncompliance. To address this concern, the authors developed a comprehensive interpersonal skills training program and a pretest-posttest evaluation. The tests were administered to two student groups one of which received the interpersonal skills instruction. The student group exposed to the training exhibited a significant positive change from pretest to posttest. Additionally the change for this group was significantly greater than the change for the group not exposed to interpersonal skills instruction.

Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders.

PubMed

Harrison, Katrin E; Dombrovski, Alexandre Y; Morse, Jennifer Q; Houck, Patricia; Schlernitzauer, Maryann; Reynolds, Charles F; Szanto, Katalin

2010-05-01

Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal thoughts and attempts. 106 individuals aged 60 years and older participated in this cross-sectional, case-control study. They were placed in three groups: suicidal depressed, non-suicidal depressed and non-depressed. Following a detailed clinical characterization, we assessed perceived social support (Interpersonal Support Evaluation List), and chronic interpersonal difficulties (Inventory of Interpersonal Problems). Using general linear models, we explored the relationship between suicidal thoughts/attempts, social support, and chronic interpersonal difficulties. We also examined whether lower perceived social support explained the relationship between chronic interpersonal difficulties and suicidal thoughts/attempts. Suicidal depressed elders reported the lowest levels of perceived social support (belonging, tangible support, and self-esteem) and higher levels of chronic interpersonal difficulties (struggle against others and interpersonal hostility), compared to both non-suicidal depressed and non-depressed elders. The relationship between chronic interpersonal difficulties and suicidal behavior was partially explained by low perceived social support. The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior.

Anger expression, self-efficacy and interpersonal competency of Korean nursing students.

PubMed

Jun, W-H

2016-12-01

The purpose of this study was to determine whether self-efficacy mediated the relationship between anger expression and interpersonal competency in South Korean nursing students. Interpersonal competency allows nursing students to increase their self-confidence in caring for patients. There is evidence of complex relationships between anger expression, self-efficacy and interpersonal competency. Self-efficacy could be considered a potential mediator in the association between anger expression and interpersonal competency in nursing students. However, few studies have investigated the mediatory role of self-efficacy in this association. A descriptive, cross-sectional study was conducted. In total, 207 Korean nursing students completed a structured questionnaire. Measurement tools included the State-Trait Anger Expression Inventory, Self-efficacy Scale and Interpersonal Competence Questionnaire. Significant correlations were observed between anger expression, self-efficacy and interpersonal competency. Self-efficacy exerted a partial mediatory effect on the relationships between interpersonal competency and anger-in and anger-control within the anger expression subscales. The study demonstrated that appropriate anger expression could result in enhanced interpersonal competency via an increase in self-efficacy. The results concerning the mediatory role of self-efficacy in the association between anger expression and interpersonal competency have provided new knowledge for nursing educators, managers and researchers, allowing them to support nursing students' interpersonal competency. Nursing schools should be required to evaluate students' anger expression patterns and to increase self-efficacy when developing education programmes that provide interpersonal training for nursing students. © 2016 International Council of Nurses.

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms.

PubMed

Erickson, Thane M; Newman, Michelle G; Siebert, Erin C; Carlile, Jessica A; Scarsella, Gina M; Abelson, James L

2016-01-01

Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms' shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N=282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N=184; 7,036 records). Additionally, depressed and anxious patients (N=47) reported symptoms and interpersonal goals in a dyadic relationship, and significant others rated patients' interpersonal goals and impact (Study 2). We derived hypotheses about prototypical interpersonal features from theories about the functions of particular symptoms and social behaviors. As expected, worry was uniquely associated with prototypically affiliative tendencies across all self-report measures in both samples, but predicted impacting significant others in unaffiliative ways. As also hypothesized, social anxiety was uniquely and prototypically associated with low dominance across measures, and general distress was associated with cold-submissive tendencies. Findings for depressive symptoms provided less consistent evidence for unique prototypical interpersonal features. Overall, results suggest the importance of multimethod assessment and accounting for general distress in interpersonal models of worry, social anxiety, and depressive symptoms. Copyright © 2015. Published by Elsevier Ltd.

Interact for What? The Relationship between Interpersonal Interaction Based on Motivation and Educational Outcomes among Students in Manufacturing Programs at Two-Year Technical Colleges

ERIC Educational Resources Information Center

Chan, Hsun-yu; Wang, Xueli

2016-01-01

Objective: This study explored the relationship between different types of interpersonal interaction, characterized by their underlying motivations, and educational outcomes among students in manufacturing programs at two-year colleges. While there exist several ways to classify interaction, motivation as an inherent attribute that fuels behaviors…

An Intervention Program Focused on Self-Understanding and Interpersonal Interactions to Prevent Psychosocial Distress among Japanese University Students

ERIC Educational Resources Information Center

Ando, Mikayo

2011-01-01

This study evaluated the impact of a preventive intervention program focused on self-understanding and interpersonal interactions to prevent psychosocial distress among Japanese university students. Two hundred and twenty-two undergraduate students were divided into a treatment group and a control group to complete Time 1 and Time 2 surveys. The…

Attachment in medical care: A review of the interpersonal model in chronic disease management.

PubMed

Jimenez, Xavier F

2017-03-01

Objective Patient-physician interaction is continually examined in an era prioritizing patient-centered approaches, yet elaboration beyond aspects of communication and empathy is lacking. Major chronic conditions would benefit tremendously from understanding interpersonal aspects of patient-physician encounters. This review intends to provide a concise introduction to the interpersonal model of attachment theory and how it informs both the patient-physician interaction and medical outcomes in chronic care. Methods A narrative review of the theoretical, neurobiological, epidemiological, investigational, and clinical literature on attachment theory and its impact on medical outcomes was conducted, utilizing a variety of key words as searched on PubMed database. Studies and reviews included were of a variety of sources, including textbooks and peer-reviewed journals. Reports in languages other than English were excluded. Results Measurable, discrete attachment styles and behavioral patterns correlate with poor medical outcomes, including nonadherence in insecure dismissing attachment and care overutilization in insecure preoccupied attachment. Furthermore, insecure dismissing attachment is associated with significant mortality. These variables can be easily assessed, and their effects are reversible, as evidenced by collaborative care outcome data. Discussion Attachment theory is useful a model with application in clinical and investigational aspects of chronic illness care. Implications and guidelines are explored.

Psychiatry, mental health nurses, and invisible power: Exploring a perturbed relationship within contemporary mental health care.

PubMed

Cutcliffe, John; Happell, Brenda

2009-04-01

Interpersonal relationships, although considered to be the cornerstone of therapeutic engagement, are replete with issues of power; yet, the concept of 'invisible power' within such formal mental health care relationships is seldom explored and/or critiqued in the literature. This paper involves an examination of power in the interpersonal relationship between the mental health nurse and the consumer. Issues of power are emphasized by drawing on examples from clinical experiences, each of which is then deconstructed as an analytical means to uncover the different layers of power. This examination highlights the existence of both obscure and seldomly acknowledged invisible manifestations of power that are inherent in psychiatry and interpersonal mental health nursing. It also identifies that there is an orthodoxy of formal mental health care that perhaps is best described as 'biopsychiatry' (or 'traditional psychiatry'). Within this are numerous serious speech acts and these provide the power for mental health practitioners to act in particular ways, to exercise control. The authors challenge this convention as the only viable discourse: a potentially viable alternative to the current of formal mental health care does exist and, most importantly, this alternative is less tied to the use of invisible power.

Family history of suicide and interpersonal functioning in suicide attempters.

PubMed

Rajalin, Mia; Hirvikoski, Tatja; Salander Renberg, Ellinor; Åsberg, Marie; Jokinen, Jussi

2017-01-01

Difficulties in interpersonal relationships are associated with a wide range of psychiatric diagnoses and have been reported as a trigger for suicidal behavior, too. The aim of this study was to examine the relationship between interpersonal problems and family history of suicide in suicide attempters and to describe relevant patterns of interpersonal problems in this patient group. The study involves 181 patients having their clinical follow-up after a suicide attempt. Family history of suicide was assessed by using the Karolinska Self Harm History Interview or retrieved in patient records. The Inventory of Interpersonal Problems was used to assess personal style in an interpersonal context. Suicide attempters with a family history of suicide had significantly more often an intrusive personal style. The results remained significant after adjustment for personality disorder. The specific interpersonal patterns associated with family history of suicide may interfere with the ability to create stable, long-lasting relationships. In regards to treatment, these personal qualities could cause difficulties in the alliance with health care personnel and make it harder for suicide attempters to accept or benefit from treatment. Attention to suicide attempters' interpersonal problems is of importance to lower their distress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation.

PubMed

Poole, Julia C; Dobson, Keith S; Pusch, Dennis

2018-06-01

Adverse childhood experiences (ACEs) are risk factors for interpersonal difficulties in adulthood, however the mechanism that underlies this association is unknown. The current study investigated the association of a wide range of ACEs with interpersonal difficulties in adulthood, and tested whether emotion dysregulation mediated the relationship between ACEs and interpersonal difficulties. Patients over the age of 18 were recruited from primary care clinics (N = 4006). Participants completed self-report questionnaires that assessed ACEs, emotion dysregulation, and interpersonal difficulties. Results indicated that, after controlling for a range of demographic variables, each type of ACE significantly predicted increased interpersonal difficulties and that cumulative ACEs predicted increased interpersonal difficulties, F(8, 3137) = 39.68, p < .001, R 2  = 0.09. Further, emotion dysregulation mediated the association between ACEs and interpersonal difficulties, B = 0.79, SE = 0.09, 95% CI [0.64, 0.97]. These findings emphasize the role of childhood adversity on interpersonal functioning in adulthood, and highlight emotion dysregulation as a mechanism by which this association occurs. Results have the potential to inform preventative and treatment efforts to improve adaptive outcomes among individuals with a history of childhood adversity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction.

PubMed

Lin, Yen-Ru; Shiah, I-Shin; Chang, Yue-Cune; Lai, Tzu-Ju; Wang, Kwua-Yun; Chou, Kuei-Ru

2004-11-01

This study's objective was to evaluate the effect of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Using a longitudinal research design, 69 participants whose scores on the Assertive Scale were < or = 50% (i.e., low assertiveness) and who were willing to participate were included and assigned to an experimental group (33 subjects) or comparison group (36 participants; participants were matched with the experimental group by grade and sex). Participants in the experimental group received eight 2-h sessions of assertiveness training once a week. Data were collected before and after training and again one month after the end of the training using the Rotter's Internal versus External Control of Reinforcement Scale, Sex Role Inventory, Assertive Scale, Esteem Scale, and Interpersonal Communication Satisfaction Inventory. The generalized estimated equation (GEE) method was used for statistical analysis. The assertiveness and self-esteem of the experimental group were significantly improved in nursing and medical students after assertiveness training, although interpersonal communication satisfaction of the experimental group was not significantly improved after the training program.

Interpersonal pathoplasticity and trajectories of change in routine adolescent and young adult residential substance abuse treatment.

PubMed

Boswell, James F; Cain, Nicole M; Oswald, Jennifer M; McAleavey, Andrew A; Adelman, Robert

2017-07-01

Partnerships between mental health care stakeholders provide a context for generalizable clinical research with implications for quality improvement. In the context of a partnership between an adolescent residential substance abuse disorder (SUD) treatment center and clinical researchers, stakeholders identified knowledge gaps (internal and the field broadly) with regard to patient interpersonal factors that influence working alliance and acute SUD residential treatment outcome trajectories. To (a) examine interpersonal pathoplasticity and identify interpersonal subtypes in a naturalistic sample of adolescent and young-adult patients presenting for routine residential SUD treatment and (b) investigate the association between identified interpersonal subtypes and working alliance and acute treatment outcome trajectories. N = 100 patients (Mage = 17.39 years, 68% male, 84% White) completed self-reports of symptom and functioning outcomes, interpersonal problems, and the working alliance on multiple occasions between admission and discharge. Multiple methods were used to identify interpersonal subtypes and test pathoplasticity. Interpersonal subtype was entered as a predictor in respective multilevel models of working alliance and symptom outcome. Interpersonal subtypes of vindictive and exploitable patients demonstrated pathoplasticity. Subtype did not predict working alliance trajectories; however, a significant interaction between interpersonal subtype and a quadratic effect for time demonstrated that exploitable patients with longer than average treatment lengths experienced attenuated symptom change over the course of treatment whereas vindictive patients appeared to demonstrate steady progress. Interpersonal assessments should be integrated into residential SUD treatment to identify patients with an exploitable interpersonal style who might require additional attention or alternative interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Relationship of Interpersonal Behaviors and Health-Related Control Appraisals to Patient Satisfaction and Compliance in a University Health Center

ERIC Educational Resources Information Center

Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.

2007-01-01

Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before…

Feasibility of Providing Culturally Relevant, Brief Interpersonal Psychotherapy for Antenatal Depression in an Obstetrics Clinic: A Pilot Study

ERIC Educational Resources Information Center

Grote, Nancy K.; Bledsoe, Sarah E.; Swartz, Holly A.; Frank, Ellen

2004-01-01

Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant,…

Interpersonal complaints regarding cancer care through a gender lens.

PubMed

Olsson, Erik Masao

2016-07-11

Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients' and relatives' complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.

The interpersonal work of dental conscious sedation: A qualitative analysis.

PubMed

Woolley, Stephen M; Chadwick, Barbara; Pugsley, Lesley

2017-08-01

Whilst there is a considerable body of literature examining the pharmacology of conscious sedation, the social tasks required to successfully provide conscious sedation have not been reported. This paper discusses data regarding the interpersonal work integral to effective conscious sedation provision, from a larger qualitative study exploring how patients and clinicians engage with secondary care conscious sedation provided within the UK. Semi-structured interviews were conducted with 13 conscious sedation providers and nine patients within UK-based secondary care sedation settings. Digital audio-recordings were transcribed verbatim and subsequently analysed using a constant comparative method within NVivo Data Analysis Software. Four main themes of interpersonal work were reported by participants: displaying care, containing emotions, demonstrating competence and maximizing the effect. This study shows that performing conscious sedation requires more than technical delivery, and involves the projection of attributes in a literal "performance." The importance of managing outward emotional appearance reflects previous dental research. The need to manage outward appearance, and the emotional impact this has, is of relevance to all clinicians. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Women's descriptions of childbirth trauma relating to care provider actions and interactions.

PubMed

Reed, Rachel; Sharman, Rachael; Inglis, Christian

2017-01-10

Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women's experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes. As part of a large mixed methods study, 748 women completed an online survey and answered the question 'describe the birth trauma experience, and what you found traumatising'. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process. Four themes were identified in the data: 'prioritising the care provider's agenda'; 'disregarding embodied knowledge'; 'lies and threats'; and 'violation'. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women's own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider's clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault. Care provider actions and interactions can influence women's experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.

[Patient satisfaction in a laboratory test collection unit].

PubMed

de Moura, Gisela Maria Schebella Souto; Hilleshein, Eunice Fabiani; Schardosim, Juliana Machado; Delgado, Kátia Simone

2008-06-01

This exploratory descriptive study aimed at identifying customer satisfaction attributes in the field of laboratory tests. Data were collected in 2006, using 104 interviews in a laboratorial unit inside a teaching hospital, using the critical incident technique, and submitted to content analysis. Three attribute categories were identified: time spent in waiting for care, interpersonal contact, and technical skills. These results subsidize the assessment of the current satisfaction survey tool, and point to its reformulation. They also allow the identification of improvement needs in customer attention, and provide elements to be taken into account in personnel selection, training programs, personnel performance assessment.

Report of workplace violence by Hispanic nurses.

PubMed

Anderson, Cheryl; Parish, Melinda

2003-07-01

Workplace violence (WPV) against nursing professionals is common. This pilot study explored the association between WPV and victim characteristics including the interpersonal risk factor of prior childhood or adult violence and gender characteristics among 90 Hispanic nurses practicing in Texas. Personal factors such as the nurses' age, clinical setting worked, years of experience, and basic education were not found to be associated with WPV. Gender and a history of violence were found to be significantly associated with WPV. Recommendations include recognition of history of childhood and/or adult violence and gender as risk factors in orientation and health care-training programs for violence prevention.

Perceptions of staff attributes in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-10-01

Qualified professional staff contribute significantly to successful health-care service delivery. Organizations view six categories of staff attributes as valued qualities of competent personnel: knowledge and experience, organizational citizenship, interpersonal skills, service orientation, personal attributes, and leadership skills. This study presents the perceptions regarding these and other staff attributes held by female clients and staff from a substance abuse treatment facility. Results indicated that four attributes were perceived as particularly influential in assisting women to reach treatment goals. These included knowledge and experience, supportiveness, nonthreatening behaviors, and availability. Attention to these variables may prove useful as treatment programs strive to improve client outcomes.

[Effects of Group Counseling Program Based on Goal Attainment Theory for Middle School Students with Emotional and Behavioral Problems].

PubMed

Jeong, In Ju; Kim, Soo Jin

2017-04-01

The purpose of this study was to examine the effects of a group counseling program based on goal attainment theory on self-esteem, interpersonal relationships, and school adjustment of middle school students with emotional and behavioral problems. Forty-four middle school students with emotional and behavioral problems (22 in the experimental group and 22 in the control group) from G city participated in this study. Data were collected from July 30 to September 24, 2015. The experimental group received the 8-session program, scheduled once a week, with each session lasting 45 minutes. Outcome variables included self-esteem, interpersonal relationship, and school adjustment. There were significant increases for self-esteem (t=3.69, p=.001), interpersonal relationship (t=8.88, p<.001), and school adjustment (t=4.92, p<.001) in the experimental group compared to the control group. These results indicate that the group counseling program based on goal attainment theory is very effective in increasing self-esteem, interpersonal relationship, and school adjustment for middle school students with emotional and behavioral problems. Therefore, it is recommended that the group counseling program based on goal attainment theory be used as an effective psychiatric nursing intervention for mental health promotion and the prevention of mental illness in adolescents. © 2017 Korean Society of Nursing Science

Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.

PubMed

Srivastava, Aradhana; Avan, Bilal I; Rajbangshi, Preety; Bhattacharyya, Sanghita

2015-04-18

Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction.

The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD): A Pilot Randomized Controlled Trial

PubMed Central

Srinivasan, Sudha M.; Kaur, Maninderjit; Park, Isabel K.; Gifford, Timothy D.; Marsh, Kerry L.; Bhat, Anjana N.

2015-01-01

We assessed the effects of three interventions, rhythm, robotic, and standard-of-care, on the imitation/praxis, interpersonal synchrony, and overall motor performance of 36 children with Autism Spectrum Disorder (ASD) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received, prior to random assignment to one of the three groups. Training was provided for 8 weeks with 4 sessions provided each week. We assessed generalized changes in motor skills from the pretest to the posttest using a standardized test of motor performance, the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2). We also assessed training-specific changes in imitation/praxis and interpersonal synchrony during an early and a late session. Consistent with the training activities practiced, the rhythm and robot groups improved on the body coordination composite of the BOT-2, whereas the comparison group improved on the fine manual control composite of the BOT-2. All three groups demonstrated improvements in imitation/praxis. The rhythm and robot groups also showed improved interpersonal synchrony performance from the early to the late session. Overall, socially embedded movement-based contexts are valuable in promoting imitation/praxis, interpersonal synchrony, and motor performance and should be included within the standard-of-care treatment for children with ASD. PMID:26793394

Real-Life Problem-Solving Thinking and Social Adjustment: Intervention for Preschool and Kindergarten Children.

ERIC Educational Resources Information Center

Shure, Myrna Beth

1979-01-01

Descriptive and evaluative information is presented about the Interpersonal Cognitive Problem Solving (ICPS) program, which utilizes sequenced games and dialogs to teach young children new ways of thinking about and coping with interpersonal difficulties. (SJL)

Informal and formal support among community-dwelling Japanese American elders living alone in Chicagoland: an in-depth qualitative study.

PubMed

Lau, Denys T; Machizawa, Sayaka; Doi, Mary

2012-06-01

A key public health approach to promote independent living and avoid nursing home placement is ensuring that elders can obtain adequate informal support from family and friends, as well as formal support from community services. This study aims to describe the use of informal and formal support among community-dwelling Nikkei elders living alone, and explore perceived barriers hindering their use of such support. We conducted English and Japanese semi-structured, open-ended interviews in Chicagoland with a convenience sample of 34 Nikkei elders age 60+ who were functionally independent and living alone; 9 family/friends; and 10 local service providers. According to participants, for informal support, Nikkei elders relied mainly on: family for homemaking and health management; partners for emotional and emergency support; friends for emotional and transportation support; and neighbors for emergency assistance. Perceived barriers to informal support included elders' attitudinal impediments (feeling burdensome, reciprocating support, self-reliance), family-related interpersonal circumstances (poor communication, distance, intergenerational differences); and friendship/neighbor-related interpersonal situations (difficulty making friends, relocation, health decline/death). For formal support, Nikkei elders primarily used adult day care/cultural programs for socializing and learning and in-home care for personal/homemaking assistance and companionship. Barriers to formal support included attitudinal impediments (stoicism, privacy, frugality); perception of care (incompatibility with services, poor opinions of in-home care quality); and accessibility (geographical distance, lack of transportation). In summary, this study provides important preliminary insights for future community strategies that will target resources and training for support networks of Nikkei elders living alone to maximize their likelihood to age in place independently.

Residency Programs' Evaluations of the Competencies: Data Provided to the ACGME About Types of Assessments Used by Programs

PubMed Central

Holt, Kathleen D.; Miller, Rebecca S.; Nasca, Thomas J.

2010-01-01

Background In 1999, the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project began to focus on resident performance in the 6 competencies of patient care, medical knowledge, professionalism, practice-based learning and improvement, interpersonal communication skills, and professionalism. Beginning in 2007, the ACGME began collecting information on how programs assess these competencies. This report provides information on the nature and extent of those assessments. Methods Using data collected by the ACGME for site visits, we use descriptive statistics and percentages to describe the number and type of methods and assessors accredited programs (n  =  4417) report using to assess the competencies. Observed differences among specialties, methodologies, and assessors are tested with analysis of variance procedures. Results Almost all (>97%) of programs report assessing all of the competencies and using multiple methods and multiple assessors. Similar assessment methods and evaluator types were consistently used across the 6 competencies. However, there were some differences in the use of patient and family as assessors: Primary care and ambulatory specialties used these to a greater extent than other specialties. Conclusion Residency programs are emphasizing the competencies in their evaluation of residents. Understanding the scope of evaluation methodologies that programs use in resident assessment is important for both the profession and the public, so that together we may monitor continuing improvement in US graduate medical education. PMID:22132294

What women want: qualitative analysis of consumer evaluations of maternity care in Queensland, Australia.

PubMed

McKinnon, Loretta C; Prosser, Samantha J; Miller, Yvette D

2014-10-26

Maternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers' expressed needs is unclear. This study examines open-text survey comments to identify women's unmet needs and priorities for maternity care. It is then considered whether these needs and priorities are addressed in current reform plans. Women who had a live single or multiple birth in Queensland, Australia, in 2010 (n 3,635) were invited to complete a retrospective self-report survey. In addition to questions about clinical and interpersonal maternity care experiences from pregnancy to postpartum, women were asked an open-ended question "Is there anything else you'd like to tell us about having your baby?" This paper describes a detailed thematic analysis of open-ended responses from a random selection of 150 women (10% of 1,510 who responded to the question). Four broad themes emerged relevant to improving women's experiences of maternity care: quality of care (interpersonal and technical); access to choices and involvement in decision-making; unmet information needs; and dissatisfaction with the care environment. Some of these topics are reflected in current reform goals, while others provide evidence of the need for further reforms. The findings reinforce the importance of some existing maternity reform objectives, and describe how these might best be met. Findings affirm the importance of information provision to enable informed choices; a goal of Queensland and national reform agendas. Improvement opportunities not currently specified in reform agendas were also identified, including the quality of interpersonal relationships between women and staff, particular unmet information needs (e.g., breastfeeding), and concerns regarding the care environment (e.g., crowding and long waiting times).

Genesis of an Employee Wellness Program at a Large University.

PubMed

Lloyd, Lisa K; Crixell, Sylvia H; Bezner, Janet R; Forester, Katherine; Swearingen, Carolyn

2017-11-01

University employee wellness programs have potential to support positive changes in employee health, thereby improving productivity and mitigating the rise in health care costs. The purpose of this article is to describe a theory-driven approach to systematically planning, developing, and implementing a comprehensive university employee wellness program. Long-term program goals were to improve employee health, well-being, and productivity by focusing on decreasing sedentary behavior, increasing physical activity, improving dietary habits, and reducing stress. An ecological approach was taken to identify levels of influence specific to a university setting: intrapersonal, interpersonal, department/college/division, and university. This framework guided the development of program components and strategies, which were grounded in several health behavior change theories. Input from supervisors and employees was incorporated throughout program development. A 15-week trial run, involving 514 employees, was evaluated to fine-tune services. Participation and feedback were positive, demonstrating that the program was valued. Support from upper administration is evidenced by continued funding. Critical factors to the successful launch of the program included a supportive administration, leverage of existing facilities and equipment, leadership provided by faculty, and service delivery by students.

One to One: Interpersonal Skills for Managers.

ERIC Educational Resources Information Center

Turner, Colin; Andrews, Philippa

This book explores interpersonal skills for college administrators through analysis of fictional, but typical, scenes and dialogues set at a fictional "Elmdale College". The analysis and discussion use transactional analysis, gestalt psychology, and neuro-linguistic programming theories to help the reader understand the underlying…

Interpersonal Skills Training for Optometry Students: What Should Be Taught?

ERIC Educational Resources Information Center

Thompson, Briony M.; Lovie-Kitchin, Jan E.

1988-01-01

Research on professionals' interpersonal skills is reviewed as a basis for selecting material for inclusion in an optometry program. Specific recommendations are made about skills necessary for enhancing patient relationships, obtaining information from patients, and providing information to patients. (MSE)

The role of the therapeutic relationship in the association between interpersonal behaviors and outcome: Comparison of two competing models.

PubMed

Dolev, Tohar; Zilcha-Mano, Sigal

2018-01-08

The patient-therapist relationship may be the mechanism behind the effect of pretreatment interpersonal patient behaviors on the outcome of psychotherapy for depression, or the factor determining for whom interpersonal behaviors affect outcome. We seek to establish which of these two alternatives receives empirical support. We conducted a secondary analysis of the findings from the Treatment for Depression Collaborative Research Program to examine two alternative models. First, a deterministic model, in which clients' ability to create satisfactory interpersonal relationships affects their ability to build a strong therapeutic relationship, which in turn affects outcome; and second, a compensation model, in which patients in a treatment focusing on interpersonal mechanisms of change and not in placebo, who compensate for their maladaptive pretreatment interpersonal behaviors by building a strong therapeutic relationship, benefit from treatment more than do patients who cannot build such relationship. The compensation, rather than the deterministic model, was supported, suggesting that the interpersonal behavior-outcome association is significantly moderated by the therapeutic relationship in interpersonal psychotherapy and not in placebo. Findings support an optimistic view whereby patients seeking treatment for maladaptive interpersonal behaviors can achieve good outcomes if work on interpersonal relationships is conducted in the presence of a strong therapeutic relationship.

Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation.

PubMed

Jean-Pierre, Pascal; Cheng, Ying; Wells, Kristen J; Freund, Karen M; Snyder, Frederick R; Fiscella, Kevin; Holden, Alan E; Paskett, Electra D; Dudley, Donald J; Simon, Melissa A; Valverde, Patricia A

2016-04-01

Patient navigation is a barrier-focused program of care coordination designed to achieve timely and high-quality cancer-related care for medically underserved racial-ethnic minorities and the poor. However, to the authors' knowledge, few studies to date have examined the relationship between satisfaction with navigators and cancer-related care. The authors included data from 1345 patients with abnormal cancer screening tests or a definitive cancer diagnosis who participated in the Patient Navigation Research Program to test the efficacy of patient navigation. Participants completed demographic questionnaires and measures of patient satisfaction with cancer-related care (PSCC) and patient satisfaction with interpersonal relationship with navigator (PSN-I). The authors obtained descriptive statistics to characterize the sample and conducted regression analyses to assess the degree of association between PSN-I and PSCC, controlling for demographic and clinical factors. Analyses of variance were conducted to examine group differences controlling for statistically significant covariates. Statistically significant relationships were found between the PSCC and PSN-I for patients with abnormal cancer screening tests (1040 patients; correlation coefficient (r), 0.4 [P<.001]) and those with a definitive cancer diagnosis (305 patients; correlation coefficient, 0.4 [P<.001]). The regression analysis indicated that having an abnormal colorectal cancer screening test in the abnormal screening test group and increased age and minority race-ethnicity status in the cancer diagnosis group were associated with a higher satisfaction with cancer care (P<.01). Satisfaction with navigators appears to be significantly associated with satisfaction with cancer-related care. Information regarding the patient-navigator relationship should be integrated into patient navigation programs to maximize the likelihood of reducing caner disparities and mortality for medically underserved racial-ethnic minorities and the poor. © 2016 American Cancer Society.

Satisfaction with Cancer Care Among Underserved Racial-Ethnic Minorities And Lower Income Patients Receiving Patient Navigation

PubMed Central

Jean-Pierre, Pascal; Cheng, Ying; Wells, Kristen J.; Freund, Karen M.; Snyder, Frederick R.; Fiscella, Kevin; Holden, Alan E.; Paskett, Electra; Dudley, Donald; Simon, Melissa A.; Valverde, Patricia

2016-01-01

BACKGROUND Patient navigation is a barrier-focused program of care coordination designed to achieve timely and high quality cancer-related care for medically underserved racial-ethnic minorities and the poor. However, few studies have examined the relationship between satisfaction with navigators and cancer-related care. METHODS We included data from 1,345 patients with abnormal cancer screening or definitive cancer diagnosis who participated in the Patient Navigation Research Program to test the efficacy of patient navigation. Participants completed demographic questionnaires and measures of Patient Satisfaction with Cancer-related Care (PSCC) and Patient Satisfaction with Interpersonal Characteristics of Navigators (PSN-I). We obtained descriptive statistics to characterize the sample, and conducted regression analyses to assess the degree of association between PSN-I and PSCC, controlling for demographic and clinical factors. We conducted analysis of variance to examine group differences controlling for statistically significant covariates. RESULTS We found statistically significant relationships between the PSCC and PSN-I for patients with abnormal cancer screening (N=1040, r=0.4, p<0.001) and definitive cancer diagnosis (N=305, r=0.4, p<0.001). The regression analysis showed that having abnormal colorectal cancer screening in the abnormal screening group and increased age and minority race-ethnicity status in the cancer diagnosis group were associated with higher satisfaction with cancer care (p<0.01). CONCLUSION Satisfaction with navigators is significantly associated with satisfaction with cancer-related care. Information about the patient-navigator relationship should be integrated in patient navigation programs to maximize the likelihood of reducing caner disparities and mortality for medically underserved racial-ethnic minorities and the poor. PMID:26849163

"Neither we are satisfied nor they"-users and provider's perspective: a qualitative study of maternity care in secondary level public health facilities, Uttar Pradesh, India.

PubMed

Bhattacharyya, Sanghita; Issac, Anns; Rajbangshi, Preety; Srivastava, Aradhana; Avan, Bilal I

2015-09-27

Quality of care provided during childbirth is a critical determinant of preventing maternal mortality and morbidity. In the studies available, quality has been assessed either from the users' perspective or the providers'. The current study tries to bring both perspectives together to identify common key focus areas for quality improvement. This study aims to assess the users' (recently delivered women) and care providers' perceptions of care to understand the common challenges affecting provision of quality maternity care in public health facilities in India. A qualitative design comprising of in-depth interviews of 24 recently delivered women from secondary care facilities and 16 health care providers in Uttar Pradesh, India. The data were analysed thematically to assess users' and providers' perspectives on the common themes. The common challenges experienced regarding provision of care were inadequate physical infrastructure, irregular supply of water, electricity, shortage of medicines, supplies, and gynaecologist and anaesthetist to manage complications, difficulty in maintaining privacy and lack of skill for post-delivery counselling. However, physical access, cleanliness, interpersonal behaviour, information sharing and out-of-pocket expenditure were concerns for only users. Similarly, providers raised poor management of referral cases, shortage of staff, non-functioning of blood bank, lack of incentives for work as their concerns. The study identified the common themes of care from both the perspectives, which have been foundrelevant in terms of challenges identified in many developing countries including India. The study framework identified new themes like management of emergencies in complicated cases, privacy and cost of care which both the group felt is relevant in the context of providing quality care during childbirth in low resource setting. The key challenges identified by both the groups can be prioritized, when developing quality improvement program in the health facilities. The identified components of care can match the supply with the demand for care and make the services truly responsive to user needs. The study highlights infrastructure, human resources, supplies and medicine as priority areas of quality improvement in the facility as perceived by both users and providers, nevertheless the interpersonal aspect of care primarily reported by the users must also not be ignored.

The State of Research on Racial/Ethnic Discrimination in The Receipt of Health Care

PubMed Central

Fagan, Pebbles; Jones, Dionne; Klein, William M. P.; Boyington, Josephine; Moten, Carmen; Rorie, Edward

2012-01-01

Objectives. We conducted a review to examine current literature on the effects of interpersonal and institutional racism and discrimination occurring within health care settings on the health care received by racial/ethnic minority patients. Methods. We searched the PsychNet, PubMed, and Scopus databases for articles on US populations published between January 1, 2008 and November 1, 2011. We used various combinations of the following search terms: discrimination, perceived discrimination, race, ethnicity, racism, institutional racism, stereotype, prejudice or bias, and health or health care. Fifty-eight articles were reviewed. Results. Patient perception of discriminatory treatment and implicit provider biases were the most frequently examined topics in health care settings. Few studies examined the overall prevalence of racial/ethnic discrimination and none examined temporal trends. In general, measures used were insufficient for examining the impact of interpersonal discrimination or institutional racism within health care settings on racial/ethnic disparities in health care. Conclusions. Better instrumentation, innovative methodology, and strategies are needed for identifying and tracking racial/ethnic discrimination in health care settings. PMID:22494002

A Qualitative Meta-Synthesis of Interpersonal Violence Prevention Programs Focused on Males.

PubMed

Taliep, Naiema; Lazarus, Sandy; Naidoo, Anthony V

2017-12-01

Exceptionally high levels of interpersonal violence have triggered a call by many experts for the need to determine effective ways to address the onset and effects of exposure to interpersonal violence. The specific aim of this study was to identify and draw on existing promising practices to make a more informed decision on strategies to develop a contextually relevant intervention that focused on the promotion of positive forms of masculinity to create safety and peace. This study used a qualitative meta-synthesis (QMS) technique to integrate and interpret findings from various intervention studies that focused on males and/or gender. An in-depth literature search yielded a total of 827 papers that met the search criteria. After removal of duplicates, abstract review, and review of the full texts, the subsequent sample for this meta-synthesis included 12 intervention programs and 23 studies. This QMS revealed the value of a comprehensive approach, using multiple strategies, employing participatory and interactive methods, and promoting social mobilization to address interpersonal violence. The promotion of positive forms of masculinity as an interpersonal violence prevention strategy is a much-needed, relatively untapped approach to generating safety and peace for both males and females.

Young women's recent experience of labour and birth care in Queensland.

PubMed

Redshaw, Maggie; Hennegan, Julie; Miller, Yvette

2014-07-01

young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15-20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. in the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. this study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time. Copyright © 2013 Elsevier Ltd. All rights reserved.

Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

PubMed

Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

2018-03-01

Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study.

PubMed

Welp, Annalena; Meier, Laurenz L; Manser, Tanja

2016-04-19

Effectively managing patient safety and clinicians' emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork. We employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role. Analyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety. The current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive-behavioral teamwork negatively impacts clinician-rated patient safety. Thus, reducing clinician emotional exhaustion is an important prerequisite of managing teamwork and patient safety. From a practical point of view, team-based interventions targeting patient safety are less likely to be effective when clinicians are emotionally exhausted.

A Study of Interpersonal Intimacy and Meaning of Life Among Elderly Institutionalized Veterans.

PubMed

Niu, Chen-Chun; Huang, Hui-Man; Hung, Yun-Ying; Lee, Hsiu-Li

2016-12-01

Most senior veterans who live in veterans' homes in Taiwan are single and have few intimate, interpersonal relationships. Aging is often accompanied by solitude and illness, which causes senior veterans to doubt the meaning of life and to lose confidence in the value of life. This study investigated the personal characteristics that influence interpersonal intimacy and the meaning of life as well as the relationship between interpersonal intimacy and the meaning of life among senior veterans living in veterans' homes. A cross-sectional design was used, and 120 senior male veterans were convenience sampled from three veterans' homes in southern Taiwan. Three structured questionnaires were used in this study: personal characteristics questionnaire, interpersonal intimacy scale, and purpose in life test. (a) Interpersonal intimacy was influenced by source of income or funds, type of residence institution, religious affiliation, and the quality of the participant's relationships with family, friends, and fellow residents. Educational level and self-perceived health status correlated positively with interpersonal intimacy, and period of residence correlated negatively with interpersonal intimacy. (b) Meaning of life was influenced by the quality of relationships with family and friends. Educational level and self-perceived health status correlated significantly and positively with meaning of life, and period of residence correlated negatively with meaning of life. (c) Significant, positive correlations were found among interpersonal intimacy, the four domains of interpersonal intimacy, and meaning of life. Health professionals involved in the care of senior veterans in institutions may use the results of this study to develop and implement interventions that promote a higher degree of interpersonal intimacy and a higher appreciation of the meaning of life, thus enabling senior veterans to confront old age in a more positive manner.

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

Eastern Caribbean Physicians' Responses to Providing HIV/AIDS Care in Resource-Limited Settings: We've Come a Long Way, but We're Not There Yet.

PubMed

Reddock, Jennifer

2016-09-01

Physicians' ability to provide care to patients living with HIV/AIDS (PLWHA) in the Eastern Caribbean is influenced by economic constraints, sociocultural norms that govern interpersonal interactions, and the pervasive stigma linked to the disease. Although the economic environment determines national capacity to acquire various treatment and monitoring technologies, Eastern Caribbean physicians respond to practicing in a resource-limited setting by making choices that are influenced by the collectivist ethos that governs interpersonal relationships. Through qualitative interviews, the study finds that the social stigma associated with the disease requires physicians to "go the extra mile" to provide care in ways that allow PLWHA to protect their privacy in small, closely networked societies. © The Author(s) 2014.

Revisiting perceptions of quality of hospice care: managing for the ultimate referral.

PubMed

Churchman, Richard; York, Grady S; Woodard, Beth; Wainright, Charles; Rau-Foster, Mary

2014-08-01

Hospice services provided in the final months of life are delivered through complex interpersonal relationships between caregivers, patients, and families. Often, service value and quality are defined by these interpersonal interactions. This understanding provides hospice leaders with an enormous opportunity to create processes that provide the optimal level of care during the last months of life. The authors argue that the ultimate referral is attained when a family member observes the care of a loved one, and the family member conveys a desire to receive the same quality of services their loved one received at that facility. The point of this article is to provide evidence that supports the methods to ultimately enhance the patient's and family's experience and increase the potential for the ultimate referral. © The Author(s) 2013.

Development and Piloting of the Prosocial Attitude Blank.

ERIC Educational Resources Information Center

Wasson, Rebecca; And Others

The Prosocial Attitude Blank (PAB) was designed to assess interpersonal values and ethical awareness of elementary school children. PAB was administered to 405 elementary students as one component of the evaluation of an intervention program designed to reduce interpersonal conflicts, increase literacy skills, and enhance children's ethical…

"I just answer 'yes' to everything they say": access to health care for deaf people in Worcester, South Africa and the politics of exclusion.

PubMed

Kritzinger, Janis; Schneider, Marguerite; Swartz, Leslie; Braathen, Stine Hellum

2014-03-01

To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-Sectional Study

PubMed Central

Rahman, Hamzah Abdul; Jarrar, Mu’taman; Don, Mohammad Sobri

2015-01-01

Background and Objective: Nursing knowledge and skills are required to sustain quality of care and patient safety. The number of nurses with Bachelor degrees in Malaysia is very limited. This study aims to predict the impact of nurse level of education on quality of care and patient safety in the medical and surgical wards in Malaysian private hospitals. Methodology: A cross-sectional survey by questionnaire was conducted. A total of 652 nurses working in the medical and surgical wards in 12 private hospitals participated in the study. Multistage stratified simple random sampling performed to invite nurses working in small size (less than 100 beds), medium size (100-199 beds) and large size (over than 200) hospitals to participate in the study. This allowed nurses from all shifts to participate in this study. Results: Nurses with higher education were not significantly associated with both quality of care and patient safety. However, a total 355 (60.9%) of respondents who participated in this study were working in teaching hospitals. Teaching hospitals offer training for all newly appointed staff. They also provide general orientation programs and training to outline the policies, procedures of the nurses’ roles and responsibilities. This made the variances between the Bachelor and Diploma nurses not significantly associated with the outcomes of care. Conclusions: Nursing educational level was not associated with the outcomes of care in Malaysian private hospitals. However, training programs and the general nursing orientation programs for nurses in Malaysia can help to upgrade the Diploma-level nurses. Training programs can increase their self confidence, knowledge, critical thinking ability and improve their interpersonal skills. So, it can be concluded that better education and training for a medical and surgical wards’ nurses is required for satisfying client expectations and sustaining the outcomes of patient care. PMID:26153190

Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study.

PubMed

Abdul Rahman, Hamzah; Jarrar, Mu'taman; Don, Mohammad Sobri

2015-04-23

Nursing knowledge and skills are required to sustain quality of care and patient safety. The numbers of nurses with Bachelor degrees in Malaysia are very limited. This study aims to predict the impact of nurse level of education on quality of care and patient safety in the medical and surgical wards in Malaysian private hospitals. A cross-sectional survey by questionnaire was conducted. A total 652 nurses working in the medical and surgical wards in 12 private hospitals were participated in the study. Multistage stratified simple random sampling performed to invite nurses working in small size (less than 100 beds), medium size (100-199 beds) and large size (over than 200) hospitals to participate in the study. This allowed nurses from all shifts to participate in this study. Nurses with higher education were not significantly associated with both quality of care and patient safety. However, a total 355 (60.9%) of respondents participated in this study were working in teaching hospitals. Teaching hospitals offer training for all newly appointed staff. They also provide general orientation programs and training to outline the policies, procedures of the nurses' roles and responsibilities. This made the variances between the Bachelor and Diploma nurses not significantly associated with the outcomes of care. Nursing educational level was not associated with the outcomes of care in Malaysian private hospitals. However, training programs and the general nursing orientation programs for nurses in Malaysia can help to upgrade the Diploma-level nurses. Training programs can increase their self confidence, knowledge, critical thinking ability and improve their interpersonal skills. So, it can be concluded that better education and training for a medical and surgical wards' nurses is required for satisfying client expectations and sustaining the outcomes of patient care.

The Memory Quilt: Heart-and-Hands Learning for Palliative Care.

PubMed

Flanagan, Patricia; DeMetro, Nancy

Nursing students' learning of adult and pediatric palliative care is a daunting experience. An effective initial teaching strategy using a Memory Quilt activity can improve nursing students' interpersonal and communication skills and help prepare them for end-of-life caring. These skills help students meet patient and family needs, as they transition to care settings.

Male College Students Using Sexually Aggressive Strategies: Findings on the Interpersonal Relationship Profile.

PubMed

Carvalho, Joana; Sá, Ana

2017-01-01

Limited interpersonal skills and relationship deficits are recognized as risk factors for sexual aggression as committed by convicted sexual offenders. Yet, less severe forms of sexual aggression are frequently perpetrated by nonforensic samples, including highly educated samples. This study was aimed at characterizing a sample of male college students reporting sexually aggressive strategies as a means to initiate sexual intercourse according to a set of interpersonal relationship factors, thus extending the knowledge on the role of interpersonal dimensions to the distinct contexts of sexual violence. Three hundred eight male college students completed a web survey assessing adult attachment styles, intimacy perception, interpersonal style, and psychosocial adjustment. Findings showed that 162 students (>50%) reported to have used some form of sexually aggressive strategy against women to initiate sexual contact. After controlling for the effects of social desirability, participants reporting sexually aggressive strategies presented significantly less confidence trusting others, more lack of perceived personal validation (within relationships), a more aggressive interpersonal style, and higher levels of hostility. Findings suggest that sexual violence, as measured in the context of college samples, may have an interpersonal nature, reflecting deficient social and intimacy skills; preventive programs are thus expected to enhance interpersonal relationship strategies as well as target individuals' perceived interpersonal vulnerability.

Interpersonal styles, peer relationships, and outcomes in residential substance use treatment.

PubMed

Harrison, Anna J; Timko, Christine; Blonigen, Daniel M

2017-10-01

Interpersonal relationships play a key role in recovery from substance use disorders (SUDs). We examined the associations between problematic interpersonal styles, peer relationships, and treatment outcomes in a sample of U.S. military veterans in residential SUD treatment. Participants were 189 veterans enrolled in a residential SUD treatment program at a Department of Veterans Affairs medical center. Participants were interviewed at the time of treatment entry (baseline), one month into treatment, and 12months following discharge from treatment. More problematic interpersonal styles at treatment entry, measured by the Inventory of Interpersonal Problems-Circumplex (IIP-C), predicted more SUD symptoms 12months post-discharge (r=0.29, P<0.01). Results of a principal components analysis of the IIP-C subscales revealed three main factors of interpersonal styles: Passive, Cruel/Aloof, and Controlling. With the exception of the Passive factor, the relationship between these interpersonal styles and SUD symptoms 12months after discharge was mediated by relationship quality with peers one month in treatment: i.e., more problematic interpersonal styles at baseline predicted poorer relationship quality with peers at 1month, which in turn predicted more SUD symptoms at 12months. Results demonstrate the importance of assessing interpersonal styles among patients in residential SUD treatment, as well as potentially augmenting existing evidence-based psychosocial treatments with a focus on interpersonal styles. Copyright © 2017 Elsevier Inc. All rights reserved.

Interpersonal stress and suicidal ideation in adolescence: An indirect association through perceived burdensomeness toward others.

PubMed

Buitron, Victor; Hill, Ryan M; Pettit, Jeremy W; Green, Kelly L; Hatkevich, Claire; Sharp, Carla

2016-01-15

Research has documented significant associations between life stress, especially interpersonal stress, and suicidal ideation in adolescents. Little is known about variables that explain the association between interpersonal stress and suicidal ideation. The present study evaluated a conceptual model in which interpersonal stress (chronic and episodic) predicted suicidal ideation indirectly via thwarted belongingness and perceived burdensomeness among 180 inpatients (65.0% girls) ages 12-17 years (M=14.72, SD=1.49). Non-interpersonal stress was also examined to determine whether the model was specific to interpersonal stress or common to stress in general. Structural equation modeling identified a significant indirect effect of chronic interpersonal stress on suicidal ideation via perceived burdensomeness. Episodic interpersonal stress was significantly correlated with thwarted belongingness and suicidal ideation, but was not a significant predictor of suicidal ideation in a model that controlled for depressive and anxious symptoms. No significant associations were found between non-interpersonal stress and suicidal ideation. Adolescents were the sole informant source, data on psychiatric diagnoses were not available, and the optimal time interval for examining stress remains unclear. The cross-sectional study design prevents conclusions regarding directionality. These findings highlight the role of chronic interpersonal stress in suicidal ideation in adolescents, as well as the potential promise of perceived burdensomeness as a target for programs designed to prevent or reduce suicidal ideation. Copyright © 2015 Elsevier B.V. All rights reserved.

Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

PubMed Central

2012-01-01

Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and interpersonal care processes emerged as being most essential to quality care. These processes are important as they have a role in mitigating adverse outcomes, promoting involvement of women in their own care, and keeping women engaged in care. The findings suggest key considerations for the planning, delivery, and evaluation of prenatal care. Most notably, care should be woman-centred and embrace shared decision making as an essential element. PMID:22502640

Academically Gifted Students' Perceived Interpersonal Competence and Peer Relationships

ERIC Educational Resources Information Center

Lee, Seon-Young; Olszewski-Kubilius, Paula; Thomson, Dana Turner

2012-01-01

Perceptions of the interpersonal competence and peer relationships of 1,526 gifted adolescents who had previously participated in academic gifted programs at the Center for Talent Development were examined, using an online survey. Major findings included that the gifted students had generally positive perceptions of their abilities to initiate,…

The development of a cultural standardized patient examination for a general surgery residency program.

PubMed

Chun, Maria B J; Young, Keane G M; Honda, Andrea F; Belcher, Gary F; Maskarinec, Gregory G

2012-01-01

Cultural competency and cross-cultural care issues in surgery resident education are areas of recognized need. The Accreditation Council for Graduate Medical Education (ACGME) has developed 6 core competencies addressing training to provide high quality care. Of these, cultural training is addressed under 3: patient care, professionalism, and interpersonal and communication skills. Our study sought to develop a measurable tool-a cultural standardized patient (SP) examination-that integrates cross-cultural care issues within the core competencies. All first year surgery residents (PGY-1) were required to participate in the videotaped cultural SP examination as part of the general surgery residency curriculum. Two measures were utilized to assess resident performance. On the same day, we administered a Cross-Cultural Care Survey. The SP examination was assessed by trained surgery teaching faculty using a written checklist that was developed to evaluate residents on all 6 ACGME competencies. Of the 26 eligible participants over 2 years, we were able to analyze the pre- and post-test results for 24 residents. The post-test score of the "attitude toward cross-cultural care" subscale of the Cross-Cultural Care Survey was significantly lower than the pre-test score (p = 0.012; Wilcoxon signed-ranks test). There were significant differences by ethnicity on all 3 subscales of the Cross-Cultural Care Survey (attitude = p < 0.05, knowledge = p < 0.01, skills = p < 0.05) on the pre-test. However, only the knowledge subscale scores remained significantly different between ethnicities on the post-test (p < 0.01). After additional assessment, evaluation, and refinement, our goal is to incorporate cross-cultural health care training as a permanent part of our curriculum. Our hope is that efforts to provide training in cross-cultural healthcare leads to high quality care and positive outcomes for the patient. This will not only enhance our training program, but may also become a useful tool for other surgery residency programs. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Physical and sexual violence and health care utilization in HIV-infected persons with alcohol problems

PubMed Central

LIEBSCHUTZ, J. M.; GEIER, J. L.; HORTON, N. J.; CHUANG, C. H.; SAMET, J. H.

2016-01-01

We examined interpersonal violence and its association with health care utilization and substance use severity among a cohort of 349 HIV-infected men and women with histories of alcohol problems assessed biannually up to 36 months. Data included demographics, lifetime interpersonal violence histories, age at first violence exposure, recent violence (prior six months), substance use severity and health care utilization (ambulatory visits, Emergency Department (ED) visits, hospitalizations) and adherence to HIV medication. Kaplan-Meier survival curves estimated the proportion of subjects experiencing recent violence. Generalized estimating equation regression models evaluated the relationship between recent violence, utilization and substance use severity over time, controlling for demographics, CD4 counts and depressive symptoms. Subject characteristics included: 79% male; mean age 41 years; 44% black, 33% white and 23% other. Eighty percent of subjects reported lifetime interpersonal violence: 40% physical violence alone, and 40% sexual violence with or without physical violence. First violence occurred prior to age 13 in 46%. Twenty-four (41%) of subjects reported recent violence by 24 and 36 months, respectively. In multivariate analyses, recent violence was associated with more ambulatory visits, ED visits and hospitalizations and worse substance use severity, but not medication adherence. Due to the high incidence and associated increased health care services utilization, violence prevention interventions should be considered for HIV-infected patients with a history of alcohol problems. PMID:16036243

Organizational Effectiveness and Patient Care Quality Study.

DTIC Science & Technology

1981-09-01

health care) 2. Interpersonal Communication (unique medical terminology) 3. Problem Solving’ 4. Team Building 5. Feedback of Patient / Consumer ...AD-AIO5 755 ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX--ETC F/0 6/5ORGANIZATIONAL EFFECTIVENESS AND PATIENT CARE QALITY STUOY.(U)SEP 51 A...care settings must consider the mission requirements of the organization, the patient care requirements, management and health care provider needs

Making Management Skills a Core Component of Medical Education.

PubMed

Myers, Christopher G; Pronovost, Peter J

2017-05-01

Physicians are being called upon to engage in greater leadership and management in increasingly complex and dynamic health care organizations. Yet, management skills are largely undeveloped in medical education. Without formal management training in the medical curriculum, physicians are left to cultivate their leadership and management abilities through a haphazard array of training programs or simply through trial and error, with consequences that may range from frustration among staff to reduced quality of care and increased risk of patient harm. To address this issue, the authors posit that medical education needs a more systematic focus on topics related to management and organization, such as individual decision making, interpersonal communication, team knowledge sharing, and organizational culture. They encourage medical schools to partner with business school faculty or other organizational scholars to offer a "Management 101" course in the medical curriculum to provide physicians-in-training with an understanding of these topics and raise the quality of physician leadership and management in modern health care organizations.

Patient satisfaction in Malaysia's busiest outpatient medical care.

PubMed

Ganasegeran, Kurubaran; Perianayagam, Wilson; Manaf, Rizal Abdul; Jadoo, Saad Ahmed Ali; Al-Dubai, Sami Abdo Radman

2015-01-01

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country's busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly "technical quality" and "accessibility and convenience," but satisfaction was low in terms of service orientation of doctors, particularly the "time spent with doctor," "interpersonal manners," and "communication" during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country's health service satisfaction.

Health system responsiveness and chronic disease care - What is the role of disease management programs? An analysis based on cross-sectional survey and administrative claims data.

PubMed

Röttger, Julia; Blümel, Miriam; Linder, Roland; Busse, Reinhard

2017-07-01

Health system responsiveness is an important aspect of health systems performance. The concept of responsiveness relates to the interpersonal and contextual aspects of health care. While disease management programs (DMPs) aim to improve the quality of health care (e.g. by improving the coordination of care), it has not been analyzed yet whether these programs improve the perceived health system responsiveness. Our study aims to close this gap by analyzing the differences in the perceived health system responsiveness between DMP-participants and non-participants. We used linked survey- and administrative claims data from 7037 patients with coronary heart disease in Germany. Of those, 5082 were enrolled and 1955 were not enrolled in the DMP. Responsiveness was assessed with an adapted version of the WHO responsiveness questionnaire in a postal survey in 2013. The survey covered 9 dimensions of responsiveness and included 17 items for each, GP and specialist care. Each item had five answer categories (very good - very bad). We handled missing values in the covariates by multiple imputation and applied propensity score matching (PSM) to control for differences between the two groups (DMP/non-DMP). We used Wilcoxon-signed-rank and McNemar test to analyze differences regarding the reported responsiveness. The PSM led to a matched and well balanced sample of 1921 pairs. Overall, DMP-participants rated the responsiveness of care more positive. The main difference was found for the coordination of care at the GP, with 62.0% of 1703 non-participants reporting a "good" or "very good" experience, compared to 69.1% of 1703 participants (p < 0.001). The results of our study indicate an overall high responsiveness for CHD-care, as well for DMP-participants as for non-participants. Yet, the results also clearly indicate that there is still a need to improve the coordination of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Changing Beliefs and Behaviors Related to Sexually Transmitted Diseases in Vulnerable Women: A Qualitative Study.

PubMed

Boroumandfar, Zahra; Kianpour, Masoud; Zargham, Ali; Abdoli, Samereh; Tayeri, Katayoun; Salehi, Mehrdad; Momeni, Godratollah; Khorvash, Farzin

2017-01-01

The first step in health education is awareness of the people and their acceptance to change their behavior. Therefore, the aim of this study was to investigate the effects of empowerment program towards the concept of self-care and prevention of sexually transmitted diseases (STDs) in women at risk of STDs. The present study was conducted as a qualitative approach (step of action and observation of an action) by using conventional content analysis method. An empowerment program regarding STDs (Action) was performed among 32 (with convenient sample) drug user women with addicted husbands referring to the counseling center for vulnerable women (drop in enter) in Isfahan in 2015. The knowledge of quiddity, transmission, and prevention of STDs, as well as some items of life skills such as self-awareness, interpersonal communication, and assertive behavior were taught in an educational program. Teaching methods were lectures, group, and individual training and role play. The impact of the program on modified belief and behavior change regarding STDs was evaluated with structured interviews. Analysis of the obtained results yielded three categories. The categories were awareness of STD, believing in being at risk, and decision and change. Promoting self-care and prevention through education programs based on action research can make a significant reduction in the incidence of problems and cause a behavior change in women with the disease or those at risk for STDs.

Teachers' and Parents' Perspectives on a Curricular Subject of "Religion and Spirituality" for Indian Schools: A Pilot Study Toward School Mental Health Program.

PubMed

Ramakrishnan, Parameshwaran; Baccari, Andrew; Ramachandran, Uma; Ahmed, Syed Faiz; Koenig, Harold G

2017-08-17

Religious-spiritual (R/S) education helps medical students cope with caregiving stress and gain skills in interpersonal empathy needed for clinical care. Such R/S education has been introduced into K-12 and college curricula in some developed nations and has been found to positively impact student's mental health. Such a move has not yet been seen in the Indian education system. This paper aimed to examine perspectives of teachers and parents in India on appropriateness, benefits, and challenges of including R/S education into the school curriculum and also to gather their impressions on how a R/S curriculum might promote students' health. A cross-sectional study of religiously stratified sample of teachers and parents was initiated in three preselected schools in India and the required sample size (N = 300) was reached through snowballing technique. A semi-structured questionnaire, with questions crafted from "Religion and Spirituality in Medicine, Physicians Perspective" (RSMPP) and "American Academy of Religion's (AAR) Guidelines for Religious Literacy," was used to determine participants' perspectives. Findings revealed that teachers' and parents' "comfort in integrating R/S into school curriculum" was associated with their gender (OR 1.68), education status (OR 1.05), and intrinsic religiosity (OR 1.05). Intrinsic religiosity was significantly (p = 0.025) high among parents while "intrinsic spirituality" was high (p = 0.020) among teachers. How participants' R/S characteristics influence their support of R/S education in school is discussed. In conclusion, participants believe R/S education will fosters students' emotional health and interpersonal skills needed for social leadership. A curriculum that incorporates R/S education, which is based on AAR guidelines and clinically validated interpersonal spiritual care tools would be acceptable to both teachers and parents.

Unconditional Space: Turning Risk into Resilience

ERIC Educational Resources Information Center

Smart, Max

2012-01-01

The concept of "space" has been used in youth care parlance to describe how and where relational care with youth takes place. Interpersonal space is central to child and youth care practice. It is the realm in which helping adults work to engage and connect with a youth. Unconditional space is designed around the "needs" of the…

Expanding the Application of Group Interventions: Emergence of Groups in Health Care Settings

ERIC Educational Resources Information Center

Drum, David; Becker, Martin Swanbrow; Hess, Elaine

2011-01-01

Changes in the health care arena and within the specialty of group work are contributing to the increased utilization of groups in health care settings. Psychoeducational, theme, and interpersonal therapy groups are highlighted for their contributions to treating challenging health conditions. An understanding of the evolution of these group…

Barriers to Gender Transition-Related Healthcare: Identifying Underserved Transgender Adults in Massachusetts

PubMed Central

White Hughto, Jaclyn M.; Rose, Adam J.; Pachankis, John E.; Reisner, Sari L.

2017-01-01

Abstract Purpose: The present study sought to examine whether individual (e.g., age, gender), interpersonal (e.g., healthcare provider discrimination), and structural (e.g., lack of insurance coverage) factors are associated with access to transition-related care in a statewide sample of transgender adults. Method: In 2013, 364 transgender residents of Massachusetts completed an electronic web-based survey online (87.1%) or in person (12.9%). A multivariable logistic regression model tested whether individual, interpersonal, and structural factors were associated with access to transition-related care. Results: Overall, 23.6% reported being unable to access transition-related care in the past 12 months. In a multivariable model, younger age, low income, low educational attainment, private insurance coverage, and healthcare discrimination were significantly associated with being unable to access transition-related care (all p<0.05). Discussion: Despite state nondiscrimination policies and universal access to healthcare, many of the Massachusetts transgender residents sampled were unable to access transition-related care. Multilevel interventions are needed, including supportive policies and policy enforcement, to ensure that underserved transgender adults can access medically necessary transition-related care. PMID:29082331

Patient Participation in Decision Making During Nursing Care in Greece--A Comparative Study.

PubMed

Kolovos, Petros; Kaitelidou, Daphne; Lemonidou, Chrysoula; Sachlas, Athanasios; Sourtzi, Panayota

2015-01-01

To describe patient participation in decision making during nursing care from patients' and nursing staff' perspectives. The sample consisted of medical and surgical patients (n = 300) and the nursing staff (n = 118) working in the respective wards in three general hospitals. A questionnaire was used for the study; data were collected from April 2009 to September 2010. Data were analyzed by an exploratory factor analysis. Patient participation was recorded at a medium level during nursing care, although it was rated as important from both patients and nursing staff. Exploratory factor analysis revealed the factor structure for the planning and implementation of the nursing care. Providers and receivers of nursing care perceived participation in a similar way. Interpersonal interaction was supported from older and less educated patients, as well as from university-educated nurses. Patient participation was greater in practical aspects of care and limited in technical medical issues and supportive services. Patient participation, although moderate, was evident during nursing care in hospital settings. Paternalism in the decision-making process was the dominant trend, whereas interpersonal interaction between the parties was recognized as a prerequisite for planning nursing care. © 2014 Wiley Periodicals, Inc.

[Family care provided by immigrant women and its impact on the quality of care and health].

PubMed

Casado-Mejía, Rosa; Ruiz-Arias, Esperanza; Solano-Parés, Ana

2012-01-01

To understand the effects of care within the family provided by live-in female immigrants on elderly dependents and their families and the carers themselves in Seville (Spain). We designed a qualitative study using in-depth interviews of key informants, immigrant care workers, elderly dependents and their families, and discussion groups composed of health professionals. The study was carried out in Seville between 2006 and 2008. The observation unit consisted of the families of elderly dependents with a live-in female immigrant care worker. The analysis units were health, care, dependence, gender, ethnicity and social class. Category analysis was carried out using QSR-NUD*ISTVivo1.3. After saturation, we triangulated among disciplines, researchers, sources and techniques to validate the results. The most important factors for carers' health were the migration process and care tasks. Interpersonal relationships constituted the principal factor affecting the health of all involved. The care tasks provided by immigrant women, together with the migration process, have an important impact on their health. Good and egalitarian interpersonal relationships are a protective factor for health. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Health-Promoting Lifestyles Among Health Care Workers in a Postdisaster Area: A Cross-sectional Study.

PubMed

Yang, Wanqiu; Sim, Timothy; Cui, Ke; Zhang, Jun; Yang, Yanchun; Ma, Xiaohong

2018-06-18

Health care workers performing rescue tasks in large-scale disaster areas are usually challenged in terms of physical and mental endurance, which can affect their lifestyles. Nevertheless, data on whether health care workers tend to adopt healthy lifestyles after disasters are limited. This paper compares the adoption of healthy lifestyle behaviors among health care workers with that among non-health care workers in a postdisaster area. This cross-sectional observational study was conducted in August 2016. The Health-Promoting Lifestyle Profile II questionnaire was used to interview 261 health care workers and 848 non-health care workers. Results of the multivariable linear models showed that health care workers had lower physical activity levels (ß=-1.363, P<.0001), worse stress management (ß=-1.282, P<.0001), slower spiritual growth (ß=-1.228, P=.002), and poorer interpersonal relationships (ß=-0.814, P=.019) than non-health care workers. However, no significant differences were found in either nutrition (ß=-0.362, P=.319) or health responsibility (ß=-0.421, P=.283). Health care workers had less healthy lifestyle behaviors, including physical activity, stress management, spiritual growth, and interpersonal relationships. Further studies are needed to develop health-improving interventions for health care workers in postdisaster areas. (Disaster Med Public Health Preparedness. 2018;page 1 of 6).

"Once when i was on call...," theory versus reality in training for professionalism.

PubMed

Eggly, Susan; Brennan, Simone; Wiese-Rometsch, Wilhelmine

2005-04-01

To identify the degree to which interns' reported experiences with professional and unprofessional behavior converge and/or diverge with ideal professional behavior proposed by the physician community. Interns at Wayne State University's residency programs in internal medicine, family medicine, and transitional medicine responded to essay questions about their experience with professional and unprofessional behavior as part of a curriculum on professionalism. Responses were coded for whether they reflected each of the principles and responsibilities outlined in a major publication on physician professionalism. Content analysis included the frequencies with which the interns' essays reflected each principle or responsibility. Additionally, a thematic analysis revealed themes of professional behavior that emerged from the essays. Interns' experiences with professional and unprofessional behavior most frequently converged with ideal behavior proposed by the physician community in categories involving interpersonal interactions with patients. Interns infrequently reported experiences involving behavior related to systems or sociopolitical issues. Interns' essays reflect their concern with interpersonal interactions with patients, but they are either less exposed to or less interested in describing behavior regarding systems or sociopolitical issues. This may be due to their stage of training or to the emphasis placed on interpersonal rather than systems or sociopolitical issues during training. The authors recommend future proposals of ideal professional behavior be revised periodically to reflect current experiences of practicing physicians, trainees, other health care providers and patients. Greater educational emphasis should be placed on the systems and sociopolitical environment in which trainees practice.

Social Skills and Problem Solving Abilities in a Middle School Advisory Setting.

ERIC Educational Resources Information Center

Ahrens, Susan; Barrett, C. Elise; Holtzman, Debi

This research project implemented and evaluated a program in interpersonal skill development designed to increase the use of applied social skills at a middle school located in northeast Illinois. Evidence of inappropriate interpersonal skills was gathered by using observation checklists, teacher and student surveys, and discipline referrals.…

Cultivating ICT Students' Interpersonal Soft Skills in Online Learning Environments Using Traditional Active Learning Techniques

ERIC Educational Resources Information Center

Myers, Trina S.; Blackman, Anna; Andersen, Trevor; Hay, Rachel; Lee, Ickjai; Gray, Heather

2014-01-01

Flexible online delivery of tertiary ICT programs is experiencing rapid growth. Creating an online environment that develops team building and interpersonal skills is difficult due to factors such as student isolation and the individual-centric model of online learning that encourages discrete study rather than teamwork. Incorporating teamwork…

Leveraging Human Assets: Interpersonal Skill Development Program

DTIC Science & Technology

2006-11-01

workforce. Washington, DC: American Psychological Association. Vroom , V . (1964). Work and motivation . New York: John Wiley. ...considering the impact of motivation on interpersonal skills. Expectancy theory ( Vroom , 1964) includes expectancy and instrumentality. Expectancy is...important for success in special operations areas such as Civil Affairs (CA) or Special Forces (SF) that work closely with indigenous populations

Instructional Patterns for Maximizing Human Potential. A Curriculum Design for Human Development and Interpersonal Relationships: Kindergarten through Adult Education.

ERIC Educational Resources Information Center

Kern Joint Union High School District, Bakersfield, CA.

Intended for consumer and homemaking education program development in kindergarten through adult education, this curriculum design emphasizes human development and interpersonal relationships. Presented in two sections, the document covers both the curriculum development process and the resulting products. The curriculum addresses five…

The simulation method in learning interpersonal communication competence--experiences of masters' degree students of health sciences.

PubMed

Saaranen, Terhi; Vaajoki, Anne; Kellomäki, Marjaana; Hyvärinen, Marja-Leena

2015-02-01

This article describes the experiences of master students of nursing science in learning interpersonal communication competence through the simulation method. The exercises reflected challenging interactive situations in the field of health care. Few studies have been published on using the simulation method in the communication education of teachers, managers, and experts in this field. The aim of this study is to produce information which can be utilised in developing the simulation method to promote the interpersonal communication competence of master-level students of health sciences. This study used the qualitative, descriptive research method. At the Department of Nursing Science, the University of Eastern Finland, students major in nursing science specialise in nursing leadership and management, preventive nursing science, or nurse teacher education. Students from all three specialties taking the Challenging Situations in Speech Communication course participated (n=47). Essays on meaningful learning experiences collected using the critical incident technique, underwent content analysis. Planning of teaching, carrying out different stages of the simulation exercise, participant roles, and students' personal factors were central to learning interpersonal communication competence. Simulation is a valuable method in developing the interpersonal communication competence of students of health sciences at the masters' level. The methods used in the simulation teaching of emergency care are not necessarily applicable as such to communication education. The role of teacher is essential to supervising students' learning in simulation exercises. In the future, it is important to construct questions that help students to reflect specifically on communication. Copyright © 2014 Elsevier Ltd. All rights reserved.

Qualitative Analysis of a Cultural Dexterity Program for Surgeons: Feasible, Impactful, and Necessary.

PubMed

Udyavar, Rhea; Smink, Douglas S; Mullen, John T; Kent, Tara S; Green, A; Harlow, Alyssa F; Castillo-Angeles, Manuel; Columbus, Alexandra B; Haider, Adil H

2018-02-15

Ineffective cross-cultural communication contributes to adverse outcomes for minority patients. To address this, the authors developed a novel curriculum for surgical residents built on the principle of cultural dexterity, emphasizing adaptability to clinical and sociocultural circumstances to tailor care to the needs of the individual patient. This study's objective was to evaluate the feasibility, acceptability, and perception of this program upon conclusion of its first year. The curriculum was implemented at 3 general surgery programs. The flipped classroom model combined independent study via e-learning modules with interactive role-playing sessions. Sessions took place over 1 academic year. Four focus groups were held, each with 6 to 9 participants, to gain feedback on the curriculum. Focus groups were recorded and transcribed, and the data were analyzed using a grounded theory approach. Five major themes emerged: (1) Role modeling from senior colleagues is integral in developing communication/interpersonal skills and attitudes toward cultural dexterity. (2) Cultural dexterity is relevant to the provision of high-quality surgical care. (3) Barriers to providing culturally dexterous care exist at the system level. (4) "Buy-in" at all levels of the institution is necessary to implement the principles of cultural dexterity. (5) The shared experience of discussing the challenges and triumphs of caring for a diverse population was engaging and impactful. Early implementation of the curriculum revealed that the tension between surgical residents' desire to improve their cultural dexterity and systemic/practical obstacles can be resolved. Combining surgically relevant didactic materials with experiential learning activities can change the paradigm of cross-cultural training. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Interpersonal Problem Areas and Alexithymia in Adolescent Girls with Loss of Control Eating

PubMed Central

Berger, Sarah Shafer; Elliott, Camden; Ranzenhofer, Lisa M.; Shomaker, Lauren B.; Hannallah, Louise; Field, Sara E.; Young, Jami F.; Sbrocco, Tracy; Wilfley, Denise E.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

2014-01-01

This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high-risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m2) between the 75th and 97th percentiles (MBMI-z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants’ interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits (as defined in the eating disorders (ED) literature) (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (ps ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at-risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes. PMID:24139852

Developing interpersonal relationships with adolescents with anorexia nervosa.

PubMed

Micevski, Valentina; McCann, Terence V

2005-09-01

Anorexia nervosa is a complex eating disorder that usually develops during adolescence. This paper reports how paediatric nurses develop professional interpersonal relationships with adolescent patients with anorexia nervosa. The study used a grounded theory approach to data collection and analysis. Data were collected using in-depth interviews from ten registered nurses who worked on a paediatric ward. The findings revealed two foci of care: 'interacting with nurses', and 'interacting with patients', with interrelated categories and strategies. A core category highlighted the importance of instigating an individual focus when developing professional interpersonal relationships with patients with anorexia. Contextual factors emphasise the broader influences that modified the way nurses developed relationships with these patients. The findings have implications for clinical practice, education, unit administration, and further research, and these are examined. Nurses who use this approach are better positioned to gain understanding of individuals experiencing the disorder and to develop professional interpersonal relationships.

"Sometimes, Somebody Just Needs Somebody - Anybody - to Care:" The power of interpersonal relationships in the lives of domestic minor sex trafficking survivors.

PubMed

O'Brien, Jennifer E

2018-04-21

Domestic minor sex trafficking (DMST) is the recruitment, harboring, transportation, provision, or obtaining of U.S. minors for the purposes of a commercial sex act. DMST victims and survivors often become involved with state-level systems including the child welfare and/or juvenile justice systems. This study presents exploratory qualitative findings regarding the role of interpersonal relationships in the lives of system-involved DMST survivors from the perspectives of DMST survivors. Results indicate survivors perceive interpersonal relationships as key to promoting risk, providing protection, and fostering resiliency over DMST. Findings from the current study not only provide a context for understanding the role of interpersonal relationships in the lives of DMST survivors but also point to directions for development of interventions targeted toward this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

[The treatment of postpartum depression with interpersonal psychotherapy and interpersonal counseling].

PubMed

Stuart, Scott; Clark, Elizabeth

2008-01-01

Perinatal depression is a prevalent disorder with a high degree of morbidity for both mother and infant. There are now empirically validated treatments for both postpartum depression and depression during pregnancy. Among these is Interpersonal Psychotherapy (IPT), which has been shown to be effective for postpartum depression across the spectrum of mild to severe depression. In fact, the limited evidence of efficacy for medication and concern about medication side effects have led some to suggest that IPT should be the first line treatment for depressed breastfeeding women. There are similar concerns about medication usage during pregnancy. Recent clinical and research experience also suggest that Interpersonal Counseling (IPC) may be effective for selected postpartum women as well. IPC, an abbreviated form of IPT, appears to be effective for mild to moderate depression, and has the potential advantage of being more amenable to delivery in primary care or OB settings.

The relationship between interpersonal problems and occupational stress in physicians.

PubMed

Falkum, Erik; Vaglum, Per

2005-01-01

This article examined the associations between occupational stress and interpersonal problems in physicians. A nationwide representative sample of Norwegian physicians received the 64-item version of the Inventory of Interpersonal Problems (IIP-64) (N=862, response rate=70%) and six instruments measuring occupational stress. Comparison of means, correlation and reliability statistics and multiple regression analyses were applied. The IIP-64 total score had a significant impact on job satisfaction, perceived unrealistic expectancies, communication with colleagues and nurses and on stress from interaction with patients. Being overly subassertive was related to low job satisfaction. Being overly expressive was linked to the experience of unrealistic expectancies from others and lack of positive feedback, whereas overly competitive physicians tended to have poorer relationships with both colleagues and nurses. Addressing interpersonal problems in medical school and postgraduate training may be a valuable measure to prevent job stress and promote quality of care.

Perceiving interpersonally-mediated risk in virtual environments

PubMed Central

Portnoy, David B.; Smoak, Natalie D.; Marsh, Kerry L.

2009-01-01

Using virtual reality (VR) to examine risky behavior that is mediated by interpersonal contact, such as agreeing to have sex, drink, or smoke with someone, offers particular promise and challenges. Social contextual stimuli that might trigger impulsive responses can be carefully controlled in virtual environments (VE), and yet manipulations of risk might be implausible to participants if they do not feel sufficiently immersed in the environment. The current study examined whether individuals can display adequate evidence of presence in a VE that involved potential interpersonally-induced risk: meeting a potential dating partner. Results offered some evidence for the potential of VR for the study of such interpersonal risk situations. Participants’ reaction to the scenario and risk-associated responses to the situation suggested that the embodied nature of virtual reality override the reality of the risk’s impossibility, allowing participants to experience adequate situational embedding, or presence. PMID:20228871

Perceiving interpersonally-mediated risk in virtual environments.

PubMed

Portnoy, David B; Smoak, Natalie D; Marsh, Kerry L

2010-03-01

Using virtual reality (VR) to examine risky behavior that is mediated by interpersonal contact, such as agreeing to have sex, drink, or smoke with someone, offers particular promise and challenges. Social contextual stimuli that might trigger impulsive responses can be carefully controlled in virtual environments (VE), and yet manipulations of risk might be implausible to participants if they do not feel sufficiently immersed in the environment. The current study examined whether individuals can display adequate evidence of presence in a VE that involved potential interpersonally-induced risk: meeting a potential dating partner. Results offered some evidence for the potential of VR for the study of such interpersonal risk situations. Participants' reaction to the scenario and risk-associated responses to the situation suggested that the embodied nature of virtual reality override the reality of the risk's impossibility, allowing participants to experience adequate situational embedding, or presence.

Interpersonal Change in Brief Supportive Psychotherapy

PubMed Central

Rosenthal, Richard N.; Muran, J. Christopher; Pinsker, Henry; Hellerstein, David; Winston, Arnold

1999-01-01

As a substudy of a manual-based outcome study of the Beth Israel Brief Psychotherapy Program, the authors studied the efficacy of supportive psychotherapy in personality change, with particular attention to changes that outlast the period of treatment. They examined results from the Inventory of Interpersonal Problems (IIP) at intake, 40th-session termination, and 6-month follow-up in the first 20 subjects randomized to the supportive group. Eight subjects (40%) dropped out, but their initial IIP scores did not differ from those of follow-up completers. Six of 10 subjects with complete 6-month follow-up data showed significant improvement in interpersonal problems (4 cases P < 0.001; 2 cases P < 0.05). In a case method design, using the IIP mapped to an interpersonal circumplex model, the authors graphically demonstrate lasting positive changes in interpersonal functioning in subjects treated with supportive psychotherapy. (The Journal of Psychotherapy Practice and Research 1999; 8:55–63) PMID:9888107

Preschool Interpersonal Relationships Predict Kindergarten Achievement: Mediated by Gains in Emotion Knowledge

PubMed Central

Torres, Marcela M.; Domitrovich, Celene E.; Bierman, Karen L.

2016-01-01

Using longitudinal data, this study tested a model in which preschool interpersonal relationships promoted kindergarten achievement in a pathway mediated by growth in emotion knowledge. The sample included 164 children attending Head Start (14% Hispanic-American, 30% African-American, 56% Caucasian; 56% girls). Preschool interpersonal relationships were indexed by student-teacher relationship closeness and positive peer interactions. Two measures of emotion knowledge (identifying emotions in photographs, recognizing emotions in stories) were assessed at the start and end of the preschool year. Structural equation models revealed that positive interpersonal relationships (with teachers and peers) predicted gains in emotion knowledge (identification, recognition) during the preschool year. Positive interpersonal relationships in preschool also predicted kindergarten achievement (controlling for initial preschool achievement); however, this association was mediated by gains in emotion knowledge during the preschool year. Implications are discussed for school readiness programs serving economically-disadvantaged children. PMID:27630379

Family-focused interventions and resources for veterans and their families.

PubMed

Sherman, Michelle D; Larsen, Jessica L

2018-05-01

Accelerated by the decreasing military presence in Iraq and Afghanistan, many military members are currently transitioning out of active duty into civilian life. Many of these new veterans have recently experienced combat deployment(s), and some are struggling with the aftermath of combat exposure, separation from family, and reintegration stressors. These challenges often follow these military families as they enter the civilian world, a time with its own major life changes vocationally, socially, and interpersonally. Although numerous resources have been developed to assist service members during their transition to the civilian world, relatively fewer exist for partners, children, and broader family systems. Family psychoeducation is a nonpathologizing, strengths-focused model of care that has documented benefits in the arena of mental illness. This article describes some manualized family psychoeducational programs and online and phone-based resources that may be useful to veteran families during this time of change. The programs and resources described herein are all available for free, primarily online. Because of a wide variety of barriers and limitations for family based care in the Veterans Affairs health care system, veteran families are and will continue to seek mental health care in public sector settings. Community providers can enhance their military culture competence by familiarizing themselves with these resources and drawing upon them in working with transitioning military families. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Development and Validation of a Cross-Country Hospital Patient Quality of Care Assessment Tool in Europe.

PubMed

Villiers-Tuthill, Amanda; Doulougeri, Karolina; McGee, Hannah; Montgomery, Anthony; Panagopoulou, Efharis; Morgan, Karen

2017-12-01

Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework. We conducted a multi-country cross-sectional study. Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed. Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities. The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.

[Effects of an intensive therapy program for behaviorally disordered mentally handicapped patients on staff personnel in residential care].

PubMed

Elbing, U; Rohmann, U H

1994-03-01

This study evaluates the effects of an intensive therapy program designed for mentally handicapped persons with severely disturbed or autistic behavior on their staff personal which had an active role in the program. The staff members rated their professional competence, quality of interaction with the client, team culture and work satisfaction before and after being engaged in the program, with additional ratings of their personal aims at the beginning of the program. Three sets of data were obtained with the program being conducted three times in a row. The testings of the related as well as the independent samples show differentiated program effects. The main effect is an increase of the professional competence and quality of interaction, especially by the qualified staff members. Trainees put emphasis on the development of their personal relationship with the client. The results are discussed in terms of the impact of learning processes specific to the roles of the staff members and motivational factors on learning and therapy outcome, along with institutional conditions influencing successful learning. Thus the program facilitates the professional and interpersonal learning process of staff members in a specific way with success as well as with limitations.

What qualities are valued in residential direct care workers from the perspective of people with an intellectual disability and managers of accommodation services?

PubMed

Dodevska, G A; Vassos, M V

2013-07-01

To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a 'good' direct care worker differently from service users with an intellectual disability (ID), with professionals placing an emphasis on describing workers with a range of practical skills and knowledge and service users placing an emphasis on describing workers with interpersonal skills. The aim of this research was to replicate this finding using a methodological approach that rectifies some of the weaknesses of previous research in this field. Semi-structured interviews were conducted to explore the qualities that are valued in residential direct care workers (RDCWs) from the perspective of seven residents with ID and seven managers of accommodation services located in metropolitan Melbourne, Australia. Thematic and chi-squared analysis confirmed the findings of previous research with residents with an ID placing more of an emphasis on the interpersonal behaviours of RDCWs in their descriptions compared to the managers. The interpersonal skills of a potential worker along with their practical skills and knowledge must be considered when recruiting RDCWs. It is also implied that given the different conceptualisation of a 'good' direct care worker across service users and professionals, increased service user participation in the organisation of appropriate supports is warranted. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: randomised controlled trial.

PubMed

Menchetti, Marco; Rucci, Paola; Bortolotti, Biancamaria; Bombi, Annarosa; Scocco, Paolo; Kraemer, Helena Chmura; Berardi, Domenico

2014-02-01

Despite depressive disorders being very common there has been little research to guide primary care physicians on the choice of treatment for patients with mild to moderate depression. To evaluate the efficacy of interpersonal counselling compared with selective serotonin reuptake inhibitors (SSRIs), in primary care attenders with major depression and to identify moderators of treatment outcome. A randomised controlled trial in nine centres (DEPICS, Australian New Zealand Clinical Trials Registry number: ACTRN12608000479303). The primary outcome was remission of the depressive episode (defined as a Hamilton Rating Scale for Depression score ≤7 at 2 months). Daily functioning was assessed using the Work and Social Adjustment Scale. Logistic regression models were used to identify moderators of treatment outcome. The percentage of patients who achieved remission at 2 months was significantly higher in the interpersonal counselling group compared with the SSRI group (58.7% v. 45.1%, P = 0.021). Five moderators of treatment outcome were found: depression severity, functional impairment, anxiety comorbidity, previous depressive episodes and smoking habit. We identified some patient characteristics predicting a differential outcome with pharmacological and psychological interventions. Should our results be confirmed in future studies, these characteristics will help clinicians to define criteria for first-line treatment of depression targeted to patients' characteristics.

Factors Associated With Injurious Falls in Residential Care Facilities.

PubMed

Towne, Samuel D; Cho, Jinmyoung; Smith, Matthew Lee; Ory, Marcia G

2017-06-01

Despite a growing literature on the epidemiology of falls, little is known about injurious falls in residential care facilities (RCFs). Addressing this gap, this study examined demographic, interpersonal, institutional, and community factors associated with injurious falls in RCFs. We conducted analyses using a nationally representative sample ( n = 733,309) of RCF residents (2010) examining whether or not a resident experienced a fall that resulted in any injury (past year). Overall, 15% of RCF residents experienced an injurious fall. Residents needing assistance with activities of daily living were more likely to experience injurious falls (adjusted-OR = 1.85), whereas males (adjusted-OR = 0.74) and those residing in smaller facilities (adjusted-OR = 0.68) were less likely. Other resident sociodemographic characteristics, payment status, social connectedness, and rurality were not significant independent predictors. Research further exploring multifactorial fall prevention screening and treatment programs in RCFs is recommended for reducing injurious falls in this understudied setting.

Testing a pharmacist-patient relationship quality model among older persons with diabetes.

PubMed

Worley, Marcia M

2006-03-01

Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort. To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied. Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis. The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model. Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.

Applying the chronic care model to prenatal care: Patient activation, productive interactions, and prenatal outcomes.

PubMed

Ledford, Christy J W; Sadler, Kerry P; Jackson, Jeremy T; Womack, Jasmyne J; Rider, Heather A; Seehusen, Angela B

2018-04-30

To demonstrate how the chronic care model can be applied in prenatal care. This study was conducted through analysis of data generated in the women's health and family medicine departments of one community hospital and two medical centers across three states (Georgia, Nevada, and Virginia). 159 low-risk obstetric patients were monitored throughout their pregnancy for patient activation and biometric measures including: blood pressure at each appointment, baby's gestational age at birth, and mode of delivery. Patient activation was assessed with the validated, licensed patient activation measure. Patient activation was strongly associated with the Prenatal Interpersonal Processes of Care metric (F (2, 155) = 3.41, p < .05). Also, increased age, decreased Prenatal Interpersonal Processes of Care, fewer pregnancies, and increased diastolic blood pressure were associated with an increased likelihood of cesarean delivery and the model correctly predicted 81% of cases. Women who identified as feeling more activated reported more positive pregnancy experiences, and women who reported more positive pregnancy experiences were more likely to experience a vaginal delivery. Activated patients, more positive prenatal experience, and improved delivery outcomes can be achieved through applying the chronic care model. Copyright © 2018 Elsevier B.V. All rights reserved.

Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

PubMed

Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

2017-01-01

Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

Little people, big lessons: an innovative strategy to develop interpersonal skills in undergraduate nursing students.

PubMed

Reid Searl, Kerry; McAllister, Margaret; Dwyer, Trudy; Krebs, Katrina Lane; Anderson, Carina; Quinney, Loretto; McLellan, Sandy

2014-09-01

Learning the skills of child health nursing requires more than technical skill development. Humanistic attributes such as being genuine, accepting and empathic are imperative in gaining the trust of a child and in helping them feel comforted and safe in a health care setting. Interpersonal theory has a long history in nursing and numerous contemporary theories have drawn on the seminal work of Peplau to advance nursing practice. However, rarely has this theory been applied to simulation learning. This paper reports on an innovative simulation technique that blends interpersonal theory with puppets. Qualitative evaluation using focus group method with fifteen undergraduate nursing students revealed that the pedagogy had a positive impact on characteristics of the learner, the learning process and on interpersonal communication skills development. The study deepened insights about the educative process and led to learning impacts that suggest that puppet-based learning is a powerful medium to bridge theory and practice, bringing the importance of interpersonal theory to life for students. Copyright © 2014 Elsevier Ltd. All rights reserved.

Primary care provider and imaging technician satisfaction with a teledermatology project in rural Veterans Health Administration clinics.

PubMed

McFarland, Lynne V; Raugi, Gregory J; Reiber, Gayle E

2013-11-01

Assessment of a multisite rural teledermatology project between 2009 and 2012 in four Pacific Northwest states that trained primary care providers and imaging technicians in state-of-the-art techniques of telemedicine. In 2012, we assessed provider and imaging technician acceptability and satisfaction with a 32-item survey instrument based on the Patient Satisfaction Questionnaire developed by Ware et al. (Eval Program Plann 1983;6:247-63) and modified for telemedicine by Kraai et al. (J Card Fail 2011;17:684-690). Survey questions covered eight satisfaction domains: interpersonal manner, technical quality, accessibility, finances, efficacy, continuity, physical environment, and availability. Overall, 71% of the primary care providers and 94% of the imaging technicians reported being satisfied or extremely satisfied with the teledermatology project. Most (95%) providers found the continuing education classes on dermatology diagnosis and treatment topics useful, and 86% reported teledermatology was a good addition to regular patient services. Most (97%) of the imaging technicians were satisfied with the ability of teledermatology to improve the description of dermatology conditions using images of the lesions or rashes, and 91% were satisfied with the convenience of teledermatology. Challenges reported by both providers and imaging technicians include an increase in workload due to more patient visits related to dermatology care and limited information technology support. Given the Veterans Health Administration's initiatives to promote accessible health care to underserved Veterans using telehealth, these findings can inform future program designs for teledermatology.

Clinician Behaviors in Telehealth Care Delivery: A Systematic Review

ERIC Educational Resources Information Center

Henry, Beverly W.; Block, Derryl E.; Ciesla, James R.; McGowan, Beth Ann; Vozenilek, John A.

2017-01-01

Literature on telehealth care delivery often addresses clinical, cost, technological, system, and organizational impacts. Less is known about interpersonal behaviors such as communication patterns and therapeutic relationship-building, which may have workforce development considerations. The purpose of this study was to conduct a systematic…

Cultural beliefs about health professionals and perceived empathy influence continuity of cancer screening following a negative encounter.

PubMed

Amador, Jael A; Flynn, Patricia M; Betancourt, Hector

2015-10-01

Negative health care encounters have implications for preventive medical services and continuity of health care. This study examined cultural and interpersonal psychological factors involved in health care interactions that may ameliorate the detrimental effects of negative encounters. A mixed-methods approach was implemented to examine the relations among positive cultural beliefs about health professionals, perceived professional empathy, interpersonal emotions, and continuity of cancer screening among 237 Latin American (Latino) and non-Latino White (Anglo) American women who reported a negative health care encounter. Multi-group structural equation modeling revealed that for Latino and Anglo women, positive cultural beliefs about health professionals in general were associated with higher perceptions of empathy regarding a professional involved in a negative encounter. In addition, for Latino women, perceptions of higher professional empathy and less negative emotions were associated with better continuity of cancer screening. Interventions designed to improve professionals' empathy skills and diverse patients' perceptions of professionals could improve patient-professional relations.

Interactional communication challenges in end-of-life care: dialectical tensions and management strategies experienced by home hospice nurses.

PubMed

Gilstrap, Cristina M; White, Zachary M

2015-01-01

This study examines the dialectical tensions experienced by home hospice nurses in interactions with patients, families, and health care providers. In-depth, semistructured interviews were conducted with 24 home hospice nurses from a mid-size for-profit hospice organization serving approximately 230 patients on an annual basis. Interviews revealed hospice nurses experience both interpersonal and organizational dialectics during hospice interactions: authoritative-nonauthoritative, revelation-concealment, independence-collaboration, and quality of care-business of care. Dialectics often resulted as a by-product of (a) responding to expectations and care choices of patients and families particular to the emotionally charged home context, (b) obtaining authorization from health care providers who are not members of the interdisciplinary team, and (c) pressures associated with providing quality patient care while fulfilling organizational role requirements. The praxis strategies used to negotiate tensions included segmentation, balance, recalibration, and spiraling inversion. Specifically, nurses employed strategies such as ascertaining family/patient acceptance, using persuasive tactics when communicating with external health care providers, relying on effective time management, and working off the clock to provide more in-person care. Although functional for patients and hospice organizations, nurses who continually rely on these strategies may experience job stress when their interpersonal commitments repeatedly conflict with organizational role demands.

A qualitative study of key stakeholders' perspectives on compassion in healthcare and the development of a framework for compassionate interpersonal relations.

PubMed

Kneafsey, Rosie; Brown, Sarah; Sein, Kim; Chamley, Carol; Parsons, Joanne

2016-01-01

To report findings from a qualitative study of key stakeholders' perspectives on 'compassion' in the health care context. To present the 'Framework for Compassionate Interpersonal Relations'. Although many research articles, health policies and health care strategies identify compassion as an underpinning value and key component of health care quality, identifying a unified definition of compassion is challenging. For Higher Education Institutions implementing 'values-based' recruitment processes, a clearer understanding of this core concept is vital. Exploratory, qualitative design. Academic staff, health care students, clinicians and service users (n = 45), participated in nine focus groups where they were asked to define compassion in the context of health care. Data were transcribed verbatim and analysed using thematic analysis. Four overarching themes were drawn from the data. The first theme centred on the participants' definitions of compassion, while the second identified compassionate behaviours. The third theme related to the barriers and threats to compassionate practice and the fourth, focused on ways to support compassion in practice. Participants believed that the health care staff should be 'consistently compassionate', and were emphatic that compassion should not be substituted with a 'care without engagement' approach. The findings concur with other research, which identifies the link between compassion and empathy and the importance of establishing meaningful connections with others. While participants in this study recognised the pressures of health care work and accepted that the expectation of 'consistent compassion' was not necessarily realistic, it was still seen as an important goal. Participants held clear expectations regarding practitioners' communication skills and used these as a proxy for compassionate practice. The 'Framework for Compassionate Inter-personal Relations' may be used to promote reflection on the implementation of compassionate practice. It may also be used to highlight areas of focus when conducting values-based recruitment activities. © 2015 John Wiley & Sons Ltd.

Mapping the role of structural and interpersonal violence in the lives of women: implications for public health interventions and policy.

PubMed

Montesanti, Stephanie Rose; Thurston, Wilfreda E

2015-11-11

Research on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions. In this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women's health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects. The different forms of violence-symbolic, structural and interpersonal-are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women. Public health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the 'lived experiences' of violence for women.

Reception of the Interpersonal Relations Series of the Continuing Education Project for Public Health Workers in North Carolina.

ERIC Educational Resources Information Center

Dutton, Donnie

Research was conducted on reactions of North Carolina public health workers to the telecasts, study manuals, and group discussion sessions used for seven programs (Introduction, Group Discussion, Communication, Cooperation, Culture and Public Health, Our Public Image, and Questions and Answers, respectively) in the interpersonal relations series…

Dialogic and Hortatory Features in the Writing of Chinese Candidates for the IELTS Test

ERIC Educational Resources Information Center

Mayor, Barbara M.

2006-01-01

Research conducted in the context of the IELTS Research Program indicates that there are recurrent features in the writing under test conditions of candidates from Chinese language backgrounds, particularly in terms of interpersonal tenor. These include a high level of interpersonal reference, combined with a heavily dialogic and hortatory style.…

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

PubMed

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

Testing a stepped care model for binge-eating disorder: a two-step randomized controlled trial.

PubMed

Tasca, Giorgio A; Koszycki, Diana; Brugnera, Agostino; Chyurlia, Livia; Hammond, Nicole; Francis, Kylie; Ritchie, Kerri; Ivanova, Iryna; Proulx, Genevieve; Wilson, Brian; Beaulac, Julie; Bissada, Hany; Beasley, Erin; Mcquaid, Nancy; Grenon, Renee; Fortin-Langelier, Benjamin; Compare, Angelo; Balfour, Louise

2018-05-24

A stepped care approach involves patients first receiving low-intensity treatment followed by higher intensity treatment. This two-step randomized controlled trial investigated the efficacy of a sequential stepped care approach for the psychological treatment of binge-eating disorder (BED). In the first step, all participants with BED (n = 135) received unguided self-help (USH) based on a cognitive-behavioral therapy model. In the second step, participants who remained in the trial were randomized either to 16 weeks of group psychodynamic-interpersonal psychotherapy (GPIP) (n = 39) or to a no-treatment control condition (n = 46). Outcomes were assessed for USH in step 1, and then for step 2 up to 6-months post-treatment using multilevel regression slope discontinuity models. In the first step, USH resulted in large and statistically significant reductions in the frequency of binge eating. Statistically significant moderate to large reductions in eating disorder cognitions were also noted. In the second step, there was no difference in change in frequency of binge eating between GPIP and the control condition. Compared with controls, GPIP resulted in significant and large improvement in attachment avoidance and interpersonal problems. The findings indicated that a second step of a stepped care approach did not significantly reduce binge-eating symptoms beyond the effects of USH alone. The study provided some evidence for the second step potentially to reduce factors known to maintain binge eating in the long run, such as attachment avoidance and interpersonal problems.

The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families.

PubMed

Wong, Sabrina T; Lynam, M Judith; Khan, Koushambhi B; Scott, Lorine; Loock, Christine

2012-10-04

The Responsive Interdisciplinary Child-Community Health Education and Research (RICHER) initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC) model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for 'at risk' children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1) access to health care for children and families with multiple forms of disadvantage and 2) patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach. This was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86) and thematic analyses of patient interview data (n=7) were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment. Respondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider's interpersonal style (e.g., being treated as an equal), was very important. Even after controlling for parents' education and ethnicity, the provider's interpersonal style remained positively associated with parent-reported empowerment (p<0.01). This model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can better meet the health and health care needs of people, especially those who are vulnerable due to multiple intersecting social determinants of health. Positive interpersonal communication from providers can play a key role in facilitating situations where individuals have an opportunity to experience success in managing their and their family's health.

Effects of a Cognitive Rehearsal Program on Interpersonal Relationships, Workplace Bullying, Symptom Experience, and Turnover Intention among Nurses: A Randomized Controlled Trial.

PubMed

Kang, Jiyeon; Kim, Jeung Im; Yun, Seonyoung

2017-10-01

This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary. © 2017 Korean Society of Nursing Science

Preparing high school students for a career in the health sciences.

PubMed

Mares, K R; Calkins, E V

1987-02-01

The Summer Scholars Programs at the University of Missouri-Kansas City School of Medicine are designed to identify talented minority or economically disadvantaged high school students and to encourage these students toward careers in the health sciences. In the summer of 1984, 31 students participated in a one-month educational program during which they observed and participated in selected patient care procedures. They developed interpersonal and interviewing skills needed for successful application to health education programs. Students were provided information about numerous health careers to help them clarify their perceptions of health roles.To assess the programs' impact, the 18 scholar participants, who were high school seniors, responded to a questionnaire that sought information about their academic program during the senior year and their plans for higher education. Responses indicated that all had pursued rigorous academic programs, had achieved at a superior level in these courses, and were enrolling in college in the fall of 1985. Fourteen of the 18 students were planning careers in medicine. Responses indicated that the students felt that the programs had been effective in helping them learn about, prepare for, and make appropriate choices regarding careers in the health sciences.

[Interpersonal games as a method for doctors' occupational stress].

PubMed

Samborska-Sablik, Anna; Sablik, Zbigniew; Gaszyński, Tomasz; Drożdż, Jarosław

2015-03-01

Doctors are frequently expose to stress during their occupational work. It is mainly the result of burdens caused by taking care of patients, dysfunctional arrangements of the health care system and difficult relationships in their workplace. Chronic stress brings negative emotions and they need to cope with them . Doctors, willing to achieve it, may initiate interpersonal games with the hidden motive of restoring their internal balance. Based on transactional analysis, the authors describe some of the games which may be found in doctors' environment: "How to get out of there", "Mine is better than yours", "Scapegoat", "Fault" and "double bind". The outcome of the games may be receiving a support, proving a benefit derived from stress, getting the feeling of being not guilty, justification, or releasing emotions in apparently unintended way. Interpersonal games may help stressed doctors to get rid of internal tension but at the same time they may be a source of stress for other participants in the games. The way to limit their destructive impact is to create such administrative and organizational solutions which allow to make working conditions more friendly. © 2015 MEDPRESS.

Clinical predictors of interpersonal functioning in patients with bipolar disorder.

PubMed

Rosa, Adriane R; Bonnin, Caterina Mar; Mazzarini, Luis; Amann, Benedikt; Kapczinski, Flavio P; Vieta, Eduard

2009-04-01

Functional impairment has been repeatedly reported in patients with bipolar disorder even during clinical remission. Less is known about specific domains, such as interpersonal relationships. The aim of this study was to identify clinical predictors of poor interpersonal relationships. Using a specific subscale of the Functioning Assessment Short Test (FAST), we assessed the interpersonal relationships of a sample of 71 euthymic bipolar (Hamilton Depression Rating Scale [HAM-D] < 8; Young Mania Rating Scale [YMRS] < 5) patients. The sample was divided into two categories: low vs. high level functioning in interpersonal relationships according to the median of the sample. Multivariate analyses were applied to identify significant predictors of interpersonal functioning. Age (p=0.026), the number of previous depressive and mixed episodes and HAM-D scores differed significantly between the two groups (p<0.05). For manic episodes, only a tendency was detected (p=0.064). After running multivariate analyses, age (p=0.026), depressive symptoms (p=0.055) and the number of previous manic episodes (p=0.033) could be considered predictors of poor interpersonal functioning. The model predicted 83.3% of the variance (R=0.59; gl=1; p<0.001). Our results indicate a link between greater impairment in interpersonal relationships and being older and having more residual symptoms and a higher number of previous manic episodes. Patients with these features should be carefully monitored and specific psychosocial interventions should be implemented to improve their outcome. Copyright © 2009 Sociedad Española de Psiquiatría and Sociedad Española de Psiquiatría Biológica. Published by Elsevier Espana. All rights reserved.

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting.

PubMed

Urquhart, Robin; Porter, Geoffrey A; Sargeant, Joan; Jackson, Lois; Grunfeld, Eva

2014-09-16

The implementation of innovations (i.e., new tools and practices) in healthcare organizations remains a significant challenge. The objective of this study was to examine the key interpersonal, organizational, and system level factors that influenced the implementation and use of synoptic reporting tools in three specific areas of cancer care. Using case study methodology, we studied three cases in Nova Scotia, Canada, wherein synoptic reporting tools were implemented within clinical departments/programs. Synoptic reporting tools capture and present information about a medical or surgical procedure in a structured, checklist-like format and typically report only items critical for understanding the disease and subsequent impacts on patient care. Data were collected through semi-structured interviews with key informants, document analysis, nonparticipant observation, and tool use/examination. Analysis involved production of case histories, in-depth analysis of each case, and a cross-case analysis. Numerous techniques were used during the research design, data collection, and data analysis stages to increase the rigour of this study. The analysis revealed five common factors that were particularly influential to implementation and use of synoptic reporting tools across the three cases: stakeholder involvement, managing the change process (e.g., building demand, communication, training and support), champions and respected colleagues, administrative and managerial support, and innovation attributes (e.g., complexity, compatibility with interests and values). The direction of influence (facilitating or impeding) of each of these factors differed across and within cases. The findings demonstrate the importance of a multi-level contextual analysis to gaining both breadth and depth to our understanding of innovation implementation and use in health care. They also provide new insights into several important issues under-reported in the literature on moving innovations into healthcare practice, including the role of middle managers in implementation efforts and the importance of attending to the interpersonal aspects of implementation.

Using Carl Rogers' person-centered model to explain interpersonal relationships at a school of nursing.

PubMed

Bryan, Venise D; Lindo, Jascinth; Anderson-Johnson, Pauline; Weaver, Steve

2015-01-01

Faculty members are viewed as nurturers within the academic setting and may be able to influence students' behaviors through the formation of positive interpersonal relationships. Faculty members' attributes that best facilitated positive interpersonal relationships according to Carl Rogers' Person-Centered Model was studied. Students (n = 192) enrolled in a 3-year undergraduate nursing program in urban Jamaica were randomly selected to participate in this descriptive cross-sectional study. A 38-item questionnaire on interpersonal relationships with nursing faculty and students' perceptions of their teachers was utilized to collect data. Factor analysis was used to create factors of realness, prizing, and empathetic understanding. Multiple linear regression analysis on the interaction of the 3 factors and interpersonal relationship scores was performed while controlling for nursing students' study year and age. One hundred sixty-five students (mean age: 23.18 ± 4.51years; 99% female) responded. The regression model explained over 46% of the variance. Realness (β = 0.50, P < .001) was the only significant predictor of the interpersonal relationship scores assigned by the nursing students. Of the total number of respondents, 99 students (60%) reported satisfaction with the interpersonal relationships shared with faculty. Nursing students' perception of faculty members' realness appeared to be the most significant attribute in fostering positive interpersonal relationships. Copyright © 2015 Elsevier Inc. All rights reserved.

Optimism, Pessimism, Mutuality, and Gender: Predicting 10-Year Role Strain in Parkinson's Disease Spouses

ERIC Educational Resources Information Center

Lyons, Karen S.; Stewart, Barbara J.; Archbold, Patricia G.; Carter, Julie H.

2009-01-01

Purpose: There is wide variability in how spouses providing care respond to their care situations. Few studies focus on the roles of both intra- and interpersonal factors in long-term spousal care, particularly in the context of Parkinson's disease (PD). The current study uses longitudinal data over a 10-year period to examine the roles of…

Effects of a brief media intervention on expectations, attitudes, and intentions of mental health help seeking.

PubMed

Demyan, Amy L; Anderson, Timothy

2012-04-01

This study examined the effects of a mass-media video intervention on expectations, attitudes, and intentions to seek help from professional mental health care services. A public service announcement-style, mass-media video intervention was developed, with prior empirical research on help-seeking behaviors organized according to the theory of reasoned action/planned behavior. In total, 228 participants were randomly assigned to 1 of 2 conditions: (a) the media-exposed intervention group, who watched programming in which the media intervention was inserted, and (b) the control group, who watched the same programming without the media intervention. The media intervention was not influential on expectation and belief-based barrier variables. However, the media intervention was effective at increasing positive attitudes toward help seeking. Findings regarding the intervention's ability to increase help-seeking intentions for interpersonal problems were complex. Implications of these findings for future research are discussed.

ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

PubMed

Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

2013-01-01

To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (p<0.0001). Practice based learning and improvement, interpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Exploring the Relevance of Attachment Theory as a Dependent Variable in the Treatment of Women Mandated into Treatment for Domestic Violence Offenses

ERIC Educational Resources Information Center

Carney, Michelle Mohr; Buttell, Frederick P.

2005-01-01

Objective: The purpose of the study was to: (a) investigate the pre-treatment levels of interpersonal dependency and violence among women entering a 16-week, court-mandated, batterer intervention program (BIP) and determine if there were any associations between interpersonal dependency and violence; (b) investigate differences in demographic…

Understanding Burnout in Child and Youth Care Workers

ERIC Educational Resources Information Center

Barford, Sean W.; Whelton, William J.

2010-01-01

Burnout is a major concern in human service occupations as it has been linked to turnover, absenteeism, a reduction in the quality of services, numerous physical and psychological disorders, and a disruption in interpersonal relations (Maslach et al. "2001"). Child and youth care workers are especially susceptible to burnout as the…

Recurrent Violent Injury: Magnitude, Risk Factors, and Opportunities for Intervention from a Statewide Analysis

PubMed Central

Kaufman, Elinore; Rising, Kristin; Wiebe, Douglas J.; Ebler, David J.; Crandall, Marie L.; Delgado, M. Kit

2016-01-01

Introduction Though preventing recurrent violent injury is an important component of a public health approach to interpersonal violence, and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established. Methods We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following patients injured in 2010 for recurrence through 2012. We assessed risk factors for recurrence with multivariable logistic regression and estimated time to recurrence with the Kaplan-Meier method. We tabulated hospital charges and costs for index and recurrent visits. Results Of 53,908 patients presenting for violent injury in 2010, 11.1% had a recurrent violent injury during the study period. Trauma centers treated 31.8%, including 55.9% of severe injuries. Among recurrers, 58.9% went to a different hospital for their second injury. Low income, homelessness, Medicaid or uninsurance, and Black race were associated with increased odds of recurrence. Patients with visits for mental and behavioral health and unintentional injury also had increased odds of recurrence. Index injuries accounted for $105 million in costs, and recurrent injuries accounted for another $25.3 million. Conclusions Recurrent violent injury is a common and costly phenomenon, and effective violence prevention programs are needed. Prevention must include the non-trauma centers where many patients seek care. PMID:27460511

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea

PubMed Central

2012-01-01

Background Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Methods Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. Results There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P <0.01). Ownership of facility, work climate, supervisory support and community support predicted 35% (R2 =0.35) of the variation in job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. Conclusions This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and work climate for rural health workers who are currently in place if they are to be satisfied in their job and productive. PMID:22691270

Rural health workers and their work environment: the role of inter-personal factors on job satisfaction of nurses in rural Papua New Guinea.

PubMed

Jayasuriya, Rohan; Whittaker, Maxine; Halim, Grace; Matineau, Tim

2012-06-12

Job satisfaction is an important focal attitude towards work. Understanding factors that relate to job satisfaction allows interventions to be developed to enhance work performance. Most research on job satisfaction among nurses has been conducted in acute care settings in industrialized countries. Factors that relate to rural nurses are different. This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a Low and Middle Income country (LMIC), Papua New Guinea. Data was collected using self administered questionnaire from rural nurses attending a training program from 15 of the 20 provinces. Results of a total of 344 nurses were available for analysis. A measure of overall job satisfaction and measures for facets of job satisfaction was developed in the study based on literature and a qualitative study. Multi-variate analysis was used to test prediction models. There was significant difference in the level of job satisfaction by age and years in the profession. Higher levels of overall job satisfaction and intrinsic satisfaction were seen in nurses employed by Church facilities compared to government facilities (P <0.01). Ownership of facility, work climate, supervisory support and community support predicted 35% (R2 =0.35) of the variation in job satisfaction. The factors contributing most were work climate (17%) and supervisory support (10%). None of these factors were predictive of an intention to leave. This study provides empirical evidence that inter-personal relationships: work climate and supportive supervision are the most important influences of job satisfaction for rural nurses in a LMIC. These findings highlight that the provision of a conducive environment requires attention to human relations aspects. For PNG this is very important as this critical cadre provide the frontline of primary health care for more than 70% of the population of the country. Many LMIC are focusing on rural health, with most of the attention given to aspects of workforce numbers and distribution. Much less attention is given to improving the aspects of the working environment that enhances intrinsic satisfaction and work climate for rural health workers who are currently in place if they are to be satisfied in their job and productive.

The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness.

PubMed

Dionne-Odom, J Nicholas; Demark-Wahnefried, Wendy; Taylor, Richard A; Rocque, Gabrielle B; Azuero, Andres; Acemgil, Aras; Martin, Michelle Y; Astin, Meka; Ejem, Deborah; Kvale, Elizabeth; Heaton, Karen; Pisu, Maria; Partridge, Edward E; Bakitas, Marie A

2017-08-01

Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. Cross-sectional survey within eight community-based southeastern U.S. cancer centers was conducted. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy. Caregivers (n = 294) averaged 66 years, were mostly female (72.8%), white (91.2%), Protestant (76.2%), retired (54.4%), and patients' spouse/partner (60.2%). Approximately, half were rural-dwellers (46.9%) with incomes <$50,000 (53.8%). Most provided support 6-7 days/week (71%) for >1 year (68%). Nearly a quarter (23%) reported high depression and 34% reported borderline or high anxiety. Low engagement in all self-care practices was associated with worse caregiver anxiety, depression, and mental HRQoL (all p values < .05). Caregivers with lower health responsibility, spiritual growth, interpersonal relation, and stress management scores had lower preparedness and decision-making self-efficacy. A significant proportion of caregivers simultaneously report low engagement in all forms of self-care practices, high depression and anxiety, and low HRQoL mental health scores. Caregiver well-being, preparedness, and decision-making self-efficacy might be optimized through interventions targeted at enhancing health responsibility, stress management, interpersonal relationships, and spiritual growth self-care practices.

Interpersonal sensitivity and persistent attenuated psychotic symptoms in adolescence.

PubMed

Masillo, Alice; Brandizzi, M; Valmaggia, L R; Saba, R; Lo Cascio, N; Lindau, J F; Telesforo, L; Venturini, P; Montanaro, D; Di Pietro, D; D'Alema, M; Girardi, P; Fiori Nastro, P

2018-03-01

Interpersonal sensitivity defines feelings of inner-fragility in the presence of others due to the expectation of criticism or rejection. Interpersonal sensitivity was found to be related to attenuated positive psychotic symptom during the prodromal phase of psychosis. The aims of this study were to examine if high level of interpersonal sensitivity at baseline are associated with the persistence of attenuated positive psychotic symptoms and general psychopathology at 18-month follow-up. A sample of 85 help-seeking individuals (mean age = 16.6, SD = 5.05) referred an Italian early detection project, completed the interpersonal sensitivity measure and the structured interview for prodromal symptoms (SIPS) at baseline and were assessed at 18-month follow-up using the SIPS. Results showed that individuals with high level of interpersonal sensitivity at baseline reported high level of attenuated positive psychotic symptoms (i.e., unusual thought content) and general symptoms (i.e., depression, irritability and low tolerance to daily stress) at follow-up. This study suggests that being "hypersensitive" to interpersonal interactions is a psychological feature associated with attenuated positive psychotic symptoms and general symptoms, such as depression and irritability, at 18-month follow-up. Assessing and treating inner-self fragilities may be an important step of early detection program to avoid the persistence of subtle but very distressing long-terms symptoms.

Anger Expression Types and Interpersonal Problems in Nurses.

PubMed

Han, Aekyung; Won, Jongsoon; Kim, Oksoo; Lee, Sang E

2015-06-01

The purpose of this study was to investigate the anger expression types in nurses and to analyze the differences between the anger expression types and interpersonal problems. The data were collected from 149 nurses working in general hospitals with 300 beds or more in Seoul or Gyeonggi province, Korea. For anger expression type, the anger expression scale from the Korean State-Trait Anger Expression Inventory was used. For interpersonal problems, the short form of the Korean Inventory of Interpersonal Problems Circumplex Scales was used. Data were analyzed using descriptive statistics, cluster analysis, multivariate analysis of variance, and Duncan's multiple comparisons test. Three anger expression types in nurses were found: low-anger expression, anger-in, and anger-in/control type. From the results of multivariate analysis of variance, there were significant differences between anger expression types and interpersonal problems (Wilks lambda F = 3.52, p < .001). Additionally, anger-in/control type was found to have the most difficulty with interpersonal problems by Duncan's post hoc test (p < .050). Based on this research, the development of an anger expression intervention program for nurses is recommended to establish the means of expressing the suppressed emotions, which would help the nurses experience less interpersonal problems. Copyright © 2015. Published by Elsevier B.V.

College Inside: A Case Study of the Design and Implementation of a Successful Prison College Program

ERIC Educational Resources Information Center

Simpkins, Betsy

2015-01-01

This chapter describes a specific initiative to offer a college program within the Oregon Department of Corrections, with a focus on the interpersonal and interinstitutional relationships needed to build such programs.

I love you ... and heroin: care and collusion among drug-using couples

PubMed Central

Simmons, Janie; Singer, Merrill

2006-01-01

Background Romantic partnerships between drug-using couples, when they are recognized at all, tend to be viewed as dysfunctional, unstable, utilitarian, and often violent. This study presents a more nuanced portrayal by describing the interpersonal dynamics of 10 heroin and cocaine-using couples from Hartford, Connecticut. Results These couples cared for each other similarly to the ways that non-drug-using couples care for their intimate partners. However, most also cared by helping each other avoid the symptoms of drug withdrawal. They did this by colluding with each other to procure and use drugs. Care and collusion in procuring and using drugs involved meanings and social practices that were constituted and reproduced by both partners in an interpersonal dynamic that was often overtly gendered. These gendered dynamics could be fluid and changed over time in response to altered circumstances and/or individual agency. They also were shaped by and interacted with long-standing historical, economic and socio-cultural forces including the persistent economic inequality, racism and other forms of structural violence endemic in the inner-city Hartford neighborhoods where these couples resided. As a result, these relationships offered both risk and protection from HIV, HCV and other health threats (e.g. arrest and violence). Conclusion A more complex and nuanced understanding of drug-using couples can be tapped for its potential in shaping prevention and intervention efforts. For example, drug treatment providers need to establish policies which recognize the existence and importance of interpersonal dynamics between drug users, and work with them to coordinate detoxification and treatment for both partners, whenever possible, as well as provide additional couples-oriented services in an integrated and comprehensive drug treatment system. PMID:16722522

Roles of sex and ethnicity in procurement coordinator--family communication during the organ donation discussion.

PubMed

Baughn, Daniel; Auerbach, Stephen M; Siminoff, Laura A

2010-09-01

Interpersonal relations with health care providers influence families' decisions to consent to solid-organ donation. However, previous research has been based on retrospective interviews with donation-eligible families and has not directly examined the interpersonal interactions between families and organ procurement coordinators. To increase understanding of the interpersonal interaction between procurement coordinators and families during the organ donation discussion, with special attention to the influence of the sex and race of the procurement coordinator and the race of the potential donor's family. A descriptive study in which standardized patients portrayed family members interacting with actual procurement coordinators in simulated donation request scenarios. Thirty-three videotaped interactions between standardized patients and 17 procurement coordinators involving 2 different scenarios depicting deceased donation were evaluated. Video recordings were rated by independent coders. Coders completed the Impact Message Inventory-Form C, the Participatory Style of Physician Scale, and the Siminoff Communication and Content and Affect Program-Global Observer Ratings scale. African American procurement coordinators, particularly African American women, were rated as more controlling and work-oriented than white procurement coordinators. Male procurement coordinators were more affiliative with the white family than the African American family, whereas female procurement coordinators were slightly less affiliative with the white family. African American procurement coordinators expressed more positive affect when interacting with the African American family than the white family, whereas the opposite was true for white procurement coordinators. Research is needed to cross-validate these exploratory findings and further examine cultural mistrust between procurement coordinators and families of ethnic minorities, especially given the negative attitudes of many minorities toward donation.

Nurses' health promoting lifestyle behaviors in a community hospital.

PubMed

Kurnat-Thoma, Emma; El-Banna, Majeda; Oakcrum, Monica; Tyroler, Jill

2017-06-01

To examine nurses' health-promoting lifestyle behaviors, describe their self-reported engagement in employee wellness program benefit options, and explore relationships between nurse demographic factors, health characteristics and lifestyle behaviors. Nurses adopting unhealthy lifestyle behaviors are at significantly higher risk for developing a number of chronic diseases and are at increased susceptibility to exhaustion, job dissatisfaction and turnover. Strengthening professional nurses' abilities to engage in healthy lifestyle behaviors could serve as a valuable tool in combating negative workplace stress, promote improved work-life balance and personal well-being, and help retain qualified health-care providers. In a 187-bed community hospital in the Washington D.C. metropolitan area, we conducted an IRB-approved exploratory descriptive study. We examined 127 nurses' demographic characteristics, self-reported employer wellness program use, and measured their healthy lifestyle behaviors using the 52-item Health-Promoting Lifestyle Profile-II (HPLP-II) survey instrument. Nurse demographic and HPLP-II scores were analyzed in SPSS v20.0. Inferential univariate statistical testing examined relationships between nurse demographic factors, health and job characteristics, and HPLP-II score outcomes. Nurses over 40years old were more likely to report participation in hospital wellness program options. Statistically significant age differences were identified in total HPLP-II score (p=0.005), and two subscale scores-spiritual growth (p=0.002) and interpersonal relations (p=0.000). Post-hoc testing identified nurse participants 40-49years old and ≥50years old experienced slightly lower total HPLP-II score, subscale scores in comparison to younger colleagues. Nurses ≥40years old may benefit from additional employer support and guidance to promote and maintain healthy lifestyles, personal well-being, and positive interpersonal relationships. Copyright © 2017 Elsevier Inc. All rights reserved.

The Socioemotional Costs and Benefits of Social-Evaluative Concerns: Do Girls Care Too Much?

PubMed Central

Rudolph, Karen D.; Conley, Colleen S.

2011-01-01

This research investigated the hypothesis that girls’ heightened concerns about social evaluation contribute to sex differences in depression and interpersonal competence during early adolescence. A short-term longitudinal study was conducted with 474 adolescents to examine the consequences of heightened social-evaluative concerns. Adolescents reported on their levels of social-evaluative concerns and depressive symptoms. Teachers provided ratings of adolescents’ competence with peers (displays of prosocial and aggressive behavior). As anticipated, girls demonstrated higher levels of social-evaluative concerns, depressive symptoms, and interpersonal competence than did boys. Moreover, path analysis confirmed that heightened social-evaluative concerns were associated both concurrently and over time with higher levels of depression, as well as with higher levels of interpersonal competence. Notably, social-evaluative concerns accounted fully for the sex difference in depression and partially for the sex difference in interpersonal competence. These findings highlight the need to consider both the socioemotional costs and benefits of sex-linked relational orientations. PMID:15660675

Interpersonal relationships and safety culture in Brazilian health care organisations.

PubMed

Migowski, Eliana R; Oliveira Júnior, Nery; Riegel, Fernando; Migowski, Sérgio A

2018-06-20

To examine the association between interpersonal relationships, nursing leadership and patient safety culture and the impact on the efficiency of hospitals. Hospitals are still affected by the increased complexity of the treatments offered and by the diverse knowledge of professionals involved, which has made this assistance model ineffective, expensive and unsustainable over time. A qualitative study of 32 professionals from three large hospitals in Southern Brazil was made. Semi-structured interviews, document analysis and analysis of electronic records were used. All the hospitals had infection rates and an average stay higher than their goal. Lack of interpersonal relationships and physicians failing to commit to organisational objectives were demonstrated. Nursing leadership styles are not definitive factors to improving patient safety and efficiency. The flaws in consolidating interpersonal relationships seem to be related to difficulties in consolidating patient safety culture, which prevented hospitals reaching their efficiency indicators. Professionals who work at the patients' bedside should be involved in the development of strategies, in order to commit them to the organisational objectives. The consolidation of interpersonal relationships of nursing professionals can lead to improvements with medical professionals, with positive impacts on patient safety and efficiency. © 2018 John Wiley & Sons Ltd.

Neural Substrate of Group Mental Health: Insights from Multi-Brain Reference Frame in Functional Neuroimaging.

PubMed

Ray, Dipanjan; Roy, Dipanjan; Sindhu, Brahmdeep; Sharan, Pratap; Banerjee, Arpan

2017-01-01

Contemporary mental health practice primarily centers around the neurobiological and psychological processes at the individual level. However, a more careful consideration of interpersonal and other group-level attributes (e.g., interpersonal relationship, mutual trust/hostility, interdependence, and cooperation) and a better grasp of their pathology can add a crucial dimension to our understanding of mental health problems. A few recent studies have delved into the interpersonal behavioral processes in the context of different psychiatric abnormalities. Neuroimaging can supplement these approaches by providing insight into the neurobiology of interpersonal functioning. Keeping this view in mind, we discuss a recently developed approach in functional neuroimaging that calls for a shift from a focus on neural information contained within brain space to a multi-brain framework exploring degree of similarity/dissimilarity of neural signals between multiple interacting brains. We hypothesize novel applications of quantitative neuroimaging markers like inter-subject correlation that might be able to evaluate the role of interpersonal attributes affecting an individual or a group. Empirical evidences of the usage of these markers in understanding the neurobiology of social interactions are provided to argue for their application in future mental health research.

Neural Substrate of Group Mental Health: Insights from Multi-Brain Reference Frame in Functional Neuroimaging

PubMed Central

Ray, Dipanjan; Roy, Dipanjan; Sindhu, Brahmdeep; Sharan, Pratap; Banerjee, Arpan

2017-01-01

Contemporary mental health practice primarily centers around the neurobiological and psychological processes at the individual level. However, a more careful consideration of interpersonal and other group-level attributes (e.g., interpersonal relationship, mutual trust/hostility, interdependence, and cooperation) and a better grasp of their pathology can add a crucial dimension to our understanding of mental health problems. A few recent studies have delved into the interpersonal behavioral processes in the context of different psychiatric abnormalities. Neuroimaging can supplement these approaches by providing insight into the neurobiology of interpersonal functioning. Keeping this view in mind, we discuss a recently developed approach in functional neuroimaging that calls for a shift from a focus on neural information contained within brain space to a multi-brain framework exploring degree of similarity/dissimilarity of neural signals between multiple interacting brains. We hypothesize novel applications of quantitative neuroimaging markers like inter-subject correlation that might be able to evaluate the role of interpersonal attributes affecting an individual or a group. Empirical evidences of the usage of these markers in understanding the neurobiology of social interactions are provided to argue for their application in future mental health research. PMID:29033866

Graduate medical education competencies for international health electives: A qualitative study.

PubMed

Nordhues, Hannah C; Bashir, M Usmaan; Merry, Stephen P; Sawatsky, Adam P

2017-11-01

Residency programs offer international health electives (IHEs), providing multiple educational benefits. This study aimed to identify how IHEs fulfill the Accreditation Council for Graduate Medical Education (ACGME) core competencies. We conducted a thematic analysis of post-rotation reflective reports from residents who participated in IHEs through the Mayo International Health Program. We coded reports using a codebook created from the ACGME competencies. Using a constant comparative method, we identified significant themes within each competency. Residents from 40 specialties participated in 377 IHEs in 56 countries from 2001 to 2014. Multiple themes were identified within each of the six ACGME core competencies: Patient Care and Procedural Skills (4), Medical Knowledge (5), Practice-Based Learning and Improvement (3), Interpersonal and Communication Skills (5), Professionalism (4), and Systems-Based Practice and Improvement (3). Themes included improving physical exam and procedural skills, providing care in resource-limited setting, gaining knowledge of tropical and non-tropical diseases, identifying socioeconomic determinants of health, engaging in the education of others, and increasing communication across cultures and multidisciplinary teams. Through IHEs, residents advanced their knowledge, skills, and attitudes in each of the six ACGME competencies. These data can be used for development of IHE competencies and milestones for resident assessment.

Patient Satisfaction in Malaysia's Busiest Outpatient Medical Care

PubMed Central

Perianayagam, Wilson; Abdul Manaf, Rizal; Ali Jadoo, Saad Ahmed; Al-Dubai, Sami Abdo Radman

2015-01-01

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country's busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly “technical quality” and “accessibility and convenience,” but satisfaction was low in terms of service orientation of doctors, particularly the “time spent with doctor,” “interpersonal manners,” and “communication” during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country's health service satisfaction. PMID:25654133

Has the quality of health care for the immigrant population changed during the economic crisis in Catalonia (Spain)? Opinions of health professionals and immigrant users.

PubMed

Porthé, Victoria; Vargas, Ingrid; Ronda, Elena; Malmusi, Davide; Bosch, Lola; Vázquez, M Luisa

2017-06-02

To analyse changes in health professionals' and immigrant users' perceptions of the quality of care provided to the immigrant population during the crisis. A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals' working conditions and users' attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

42 CFR 494.140 - Condition: Personnel qualifications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... is employed as a dialysis technician; and (2) Have a high school diploma or equivalency; (3) Have..., providing direct patient care, and communication and interpersonal skills, including patient sensitivity...

42 CFR 494.140 - Condition: Personnel qualifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... is employed as a dialysis technician; and (2) Have a high school diploma or equivalency; (3) Have..., providing direct patient care, and communication and interpersonal skills, including patient sensitivity...

42 CFR 494.140 - Condition: Personnel qualifications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... is employed as a dialysis technician; and (2) Have a high school diploma or equivalency; (3) Have..., providing direct patient care, and communication and interpersonal skills, including patient sensitivity...

42 CFR 494.140 - Condition: Personnel qualifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... is employed as a dialysis technician; and (2) Have a high school diploma or equivalency; (3) Have..., providing direct patient care, and communication and interpersonal skills, including patient sensitivity...

What Would Pete Say?

ERIC Educational Resources Information Center

Berk, Richard A.

2007-01-01

Peter Rossi's reputation was built on a pragmatic and careful approach to research practice. He cared most about facts: getting the facts right, and then communicating those facts in an earthy, accessible, and witty manner. At the same time, Pete had a brash interpersonal style and a taste for taking on some of the most controversial policy…

Interpersonal Complexity: A Cognitive Component of Person-Centered Care

ERIC Educational Resources Information Center

Medvene, Louis; Grosch, Kerry; Swink, Nathan

2006-01-01

Purpose: This study concerns one component of the ability to provide person-centered care: the cognitive skill of perceiving others in relatively complex terms. This study tested the effectiveness of a social motivation for increasing the number of psychological constructs used to describe an unfamiliar senior citizen. Design and Methods:…

Effective Interpersonal Communication: A Practical Guide to Improve Your Life.

PubMed

Vertino, Kathleen A

2014-09-30

Use of effective interpersonal communication strategies by nurses in both personal and professional settings, may reduce stress, promote wellness, and therefore, improve overall quality of life. This article briefly explores the concept of interpersonal communication as it relates to Maslow's hierarchy of human needs; describes personal variables and the interaction of internal and external variables that can impact communication; and discusses possible causes and consequences of ineffective communication. Drawing on both the literature and experiences as a longtime provider of care in the mental health field, the author offers multiple practical strategies, with specific examples of possible responses for effective communication. Recommendations in this article are intended for nurses to consider as they seek healthy communication strategies that may be useful in both their personal and professional lives.

Conversational Skills Instruction for Communication Apprehension and Avoidance: Evaluation of a Treatment Program.

ERIC Educational Resources Information Center

Glaser, Susan R.; And Others

1983-01-01

Describes and evaluates a conversational skills program designed to teach apprehensive communicators how to develop comfortable and effective social behavior in a variety of interpersonal contexts. (PD)

Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care.

PubMed

Urquhart, Robin; Porter, Geoffrey A; Grunfeld, Eva; Sargeant, Joan

2012-03-01

The dominant method of reporting findings from diagnostic and surgical procedures is the narrative report. In cancer care, this report inconsistently provides the information required to understand the cancer and make informed patient care decisions. Another method of reporting, the synoptic report, captures specific data items in a structured manner and contains only items critical for patient care. Research demonstrates that synoptic reports vastly improve the quality of reporting. However, synoptic reporting represents a complex innovation in cancer care, with implementation and use requiring fundamental shifts in physician behaviour and practice, and support from the organization and larger system. The objective of this study is to examine the key interpersonal, organizational, and system-level factors that influence the implementation and use of synoptic reporting in cancer care. This study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study. This study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.

An Evaluation of a High School Peer Mediation Program.

ERIC Educational Resources Information Center

Terry, Brenda L.; Gerber, Sterling

This article provides results about a high school's support for its peer mediation program and the effectiveness of that program. The four subject groups surveyed included faculty, students in eight home room classes, trained student mediators, and students who had used the program to resolve an interpersonal conflict. Individuals directly…

Behavioral interventions for office-based care: depressive disorders.

PubMed

James, Ernest; Larzelere, Michele McCarthy

2014-03-01

Depressive disorders commonly are diagnosed and managed in primary care settings, and many patients prefer a nonpharmacologic approach. Traditionally, symptom reduction through pharmacotherapy has been the primary focus of management, but there is a growing acknowledgment of the need to develop modalities that prevent subsequent relapse and recurrences. Psychotherapy, including cognitive behavioral and interpersonal therapies, can have enduring effects that reduce subsequent risk in ways that drugs cannot. Although most family physicians do not provide formal psychosocial interventions for depression, brief interventions and behavioral intervention technologies, such as those that deliver care via the Internet or mobile device, are key means of increasing access to psychotherapy. For children and adolescents with mild, uncomplicated depression, physician-provided social support, encouragement, and reinforcement of adaptive behavior patterns can be as effective as cognitive behavioral therapy. In addition, a primary care physician's involvement in parent education and safety planning for suicide prevention holds promise for risk reduction. Evidence also supports the use of problem-solving therapy and components of cognitive behavioral therapy and interpersonal psychotherapy provided by primary care physicians for patients with depression. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Stressors in clinical nursing education in Iran: A systematic review.

PubMed

Changiz, Tahereh; Malekpour, Alireza; Zargham-Boroujeni, Ali

2012-09-01

Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students' learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports. In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also, the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of clinical education AND Nursing), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in Tables. THE FOLLOWING THEMES WERE OBTAINED TO CLASSIFY MAIN AREAS OF IMPORTANCE FOR FACTORS RELATED TO STRESS IN CLINICAL NURSING EDUCATION: a) clinical competence and ability to play one's roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme. Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that interpersonal relationships and interactions is of the highest priority.

Social skills training as nursing intervention to improve the social skills and self-esteem of inpatients with chronic schizophrenia.

PubMed

Seo, Ji-Min; Ahn, Sukhee; Byun, Eun-Kyung; Kim, Chul-Kweon

2007-12-01

The effects of social skills training on the social skills and self-esteem of 66 patients with chronic schizophrenia were evaluated using the basic training and problem-solving training models. The experimental group received 16 group training sessions, and the control group received routine nursing care. The training program consisted of two parts: conversational skills and assertiveness skills. Data were collected at pretreatment and posttreatment. The conversational, interpersonal relationship, and assertiveness skills, and self-esteem of the experimental group showed significant improvement, whereas problem-solving skills did not improve. The results indicate that training in social skills is effective for improving the social skills and self-esteem of inpatients with chronic schizophrenia.

Understanding the optimal learning environment in palliative care.

PubMed

Connell, Shirley E; Yates, Patsy; Barrett, Linda

2011-07-01

The learning experiences of student nurses undertaking clinical placement are reported widely, however little is known about the learning experiences of health professionals undertaking continuing professional development (CPD) in a clinical setting, especially in palliative care. The aim of this study, which was conducted as part of the national evaluation of a professional development program involving clinical attachments with palliative care services (The Program of Experience in the Palliative Approach [PEPA]), was to explore factors influencing the learning experiences of participants over time. Thirteen semi-structured, one-to-one telephone interviews were conducted with five participants throughout their PEPA experience. The analysis was informed by the traditions of adult, social and psychological learning theories and relevant literature. The participants' learning was enhanced by engaging interactively with host site staff and patients, and by the validation of their personal and professional life experiences together with the reciprocation of their knowledge with host site staff. Self-directed learning strategies maximised the participants' learning outcomes. Inclusion in team activities aided the participants to feel accepted within the host site. Personal interactions with host site staff and patients shaped this social/cultural environment of the host site. Optimal learning was promoted when participants were actively engaged, felt accepted and supported by, and experienced positive interpersonal interactions with, the host site staff. Copyright © 2010 Elsevier Ltd. All rights reserved.

The American Board of Radiology Maintenance of Certification (MOC) Program in Radiologic Physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Stephen R.; Hendee, William R.; Paliwal, Bhudatt R.

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document the professional development of each diplomate of The American Board of Radiology (ABR) through its focus on the essential elements of quality care in Diagnostic Radiology and its subspecialties, and in the specialties of Radiation Oncology and Radiologic Physics. The initial elements of the ABR-MOC have been developed in accord with guidelines of The American Board of Medical Specialties. All diplomates with a ten-year,more » time-limited primary certificate in Diagnostic Radiologic Physics, Therapeutic Radiologic Physics, or Medical Nuclear Physics who wish to maintain certification must successfully complete the requirements of the appropriate ABR-MOC program for their specialty. Holders of multiple certificates must meet ABR-MOC requirements specific to the certificates held. Diplomates with lifelong certificates are not required to participate in the MOC, but are strongly encouraged to do so. MOC is based on documentation of individual participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Within these components, MOC addresses six competencies: medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice.« less

Identifying Perceived Barriers along the HIV Care Continuum: Findings from Providers, Peer Educators, and Observations of Provider–Patient Interactions in Ethiopia

PubMed Central

Kulkarni, Sarah; Hoffman, Susie; Gadisa, Tsigereda; Melaku, Zenebe; Fantehun, Mesganaw; Yigzaw, Muluneh; El-Sadr, Wafaa; Remien, Robert; Tymejczyk, Olga; Nash, Denis; Elul, Batya

2015-01-01

Increasing the proportion of HIV-positive individuals who link promptly to and are retained in care remains challenging in sub- Saharan Africa, but little evidence is available from the provider perspective. In 4 Ethiopian health facilities, we (1) interviewed providers and peer educators about their perceptions of service delivery- and patient-level barriers and (2) observed provider–patient interactions to characterize content and interpersonal aspects of counseling. In interviews, providers and peer educators demonstrated empathy and identified nonacceptance of HIV status, anticipated stigma from unintended disclosure, and fear of antiretroviral therapy as patient barriers, and brusque counseling and insufficient counseling at provider-initiated testing sites as service delivery-related. However, observations from the same clinics showed that providers often failed to elicit patients’ barriers to retention, making it unlikely these would be addressed during counseling. Training is needed to improve interpersonal aspects of counseling and ensure providers elicit and address barriers to HIV care experienced by patients. PMID:26173944

The art of letting go: referral to palliative care and its discontents.

PubMed

Broom, Alex; Kirby, Emma; Good, Phillip; Wootton, Julia; Adams, Jon

2013-02-01

Accompanying patients from active treatment towards specialist palliative care is a complex sphere of clinical practice that can be fraught with interpersonal and emotional challenges. While medical specialists are expected to break 'bad news' to their patients and ease their transitions to specialist palliative care if required, few have received formal training in such interpersonal complexities. Furthermore, there also often exists clinical ambiguity around whether to continue active treatment vis-à-vis refocusing on quality of life and palliation. In this paper we explore the experiences of twenty Australian medical specialists, focussing on issues such as: dilemmas around when and how to talk about dying and palliation; the art of referral and practices of representation; and, accounts of emotion and subjective influences on referral. The results illustrate how this transitional realm can be embedded in emotions, relationships and the allure of potentially life-prolonging intervention. We argue that the practice of referral should be understood as a relational and contextually-bound process. Copyright © 2012 Elsevier Ltd. All rights reserved.

Use of the Rasch model for initial testing of fit statistics and rating scale diagnosis for a general anesthesia satisfaction questionnaire.

PubMed

Hawkins, Robert J; Kremer, Michael J; Swanson, Barbara; Fogg, Lou; Pierce, Penny; Pearson, Julie

2014-01-01

The level of patient satisfaction is a result of a complex set of interactions between the patient and the health care provider. It is important to quantify satisfaction with care because it involves the patient in the care experience and decreases the potential gap between expected and actual care delivered. We tested a preliminary 23-item instrument to measure patient satisfaction with general anesthesia care. The rating scale Rasch model was chosen as the framework. There were 10 items found to have sufficient evidence of stable fit statistics. Items included 2 questions related to information provided, 2 questions related to concern and kindness of the provider, and 1 question each for interpersonal skills of the provider, attention by the provider, feeling safe, well-being, privacy, and overall anesthesia satisfaction. Such actions as providing enough time to understand the anesthesia plan, answering questions related to the anesthetic, showing kindness and concern for the patient, displaying good interpersonal skills, providing adequate attention to the patient, providing a safe environment that maintains privacy and provides a sense of well-being are important actions that are well within the control of individual anesthesia providers and may lead to improved care from the perception of the patient.

The Importance of and the Complexities Associated With Measuring Continuity of Care During Resident Training: Possible Solutions Do Exist.

PubMed

Carney, Patricia A; Conry, Colleen M; Mitchell, Karen B; Ericson, Annie; Dickinson, W Perry; Martin, James C; Carek, Peter J; Douglass, Alan B; Eiff, M Patrice

2016-04-01

Evolutions in care delivery toward the patient-centered medical home have influenced important aspects of care continuity. Primary responsibility for a panel of continuity patients is a foundational requirement in family medicine residencies. In this paper we characterize challenges in measuring continuity of care in residency training in this new era of primary care. We synthesized the literature and analyzed information from key informant interviews and group discussions with residency faculty and staff to identify the challenges and possible solutions for measuring continuity of care during family medicine training. We specifically focused on measuring interpersonal continuity at the patient level, resident level, and health care team level. Challenges identified in accurately measuring interpersonal continuity of care during residency training include: (1) variability in empanelment approaches for all patients, (2) scheduling complexity in different types of visits, (3) variability in ability to attain continuity counts at the level of the resident, and (4) shifting make-up of health care teams, especially in residency training. Possible solutions for each challenge are presented. Philosophical issues related to continuity are discussed, including whether true continuity can be achieved during residency training and whether qualitative rather than quantitative measures of continuity are better suited to residencies. Measuring continuity of care in residency training is challenging but possible, though improvements in precision and assessment of the comprehensive nature of the relationships are needed. Definitions of continuity during training and the role continuity measurement plays in residency need further study.

Interpersonal Stance in L1 and L2 Students' Argumentative Writing in Economics: Implications for Faculty Development in WAC/WID Programs

ERIC Educational Resources Information Center

Lancaster, Zak

2011-01-01

This article offers a linguistic analysis of interpersonal stancetaking in four argumentative term papers written in an upper-level undergraduate course in economics. Two of the papers were written by English L2 writers who experienced particular difficulty with the assignment and two by English L1 writers who received the highest grades among the…

Facilitating interpersonal interaction and learning online: linking theory and practice.

PubMed

Sargeant, Joan; Curran, Vernon; Allen, Michael; Jarvis-Selinger, Sandra; Ho, Kendall

2006-01-01

An earlier study of physicians' perceptions of interactive online learning showed that these were shaped both by program design and quality and the quality and quantity of interpersonal interaction. We explore instructor roles in enhancing online learning through interpersonal interaction and the learning theories that inform these. This was a qualitative study using focus groups and interviews. Using purposive sampling, 50 physicians were recruited based on their experience with interactive online CME and face-to-face CME. Qualitative thematic and interpretive analysis was used. Two facilitation roles appeared key: creating a comfortable learning environment and enhancing the educational value of electronic discussions. Comfort developed gradually, and specific interventions like facilitating introductions and sharing experiences in a friendly, informative manner were helpful. As in facilitating effective small-group learning, instructors' thoughtful use of techniques that facilitated constructive interaction based on learner's needs and practice demands contributed to the educational value of interpersonal interactions. Facilitators require enhanced skills to engage learners in meaningful interaction and to overcome the transactional distance of online learning. The use of learning theories, including behavioral, cognitive, social, humanistic, and constructivist, can strengthen the educational design and facilitation of online programs. Preparation for online facilitation should include instruction in the roles and techniques required and the theories that inform them.

Cultural Adaptation in Outdoor Programming

ERIC Educational Resources Information Center

Fabrizio, Sheila M.; Neill, James

2005-01-01

Outdoor programs often intentionally provide a different culture and the challenge of working out how to adapt. Failure to adapt, however, can cause symptoms of culture shock, including homesickness, negative personal behavior, and interpersonal conflict. This article links cross-cultural and outdoor programming literature and provides case…

A Qualitative Investigation of Adolescents’ Perceived Mechanisms of Change from a Universal School-Based Depression Prevention Program

PubMed Central

Shochet, Ian; Montague, Roslyn; Smith, Coral; Dadds, Mark

2014-01-01

A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from an evidence-based depression prevention intervention, the Resourceful Adolescent Program (RAP-A). Fifty-four percent of interviewees articulated at least one specific example of program benefit. A thematic analysis of responses revealed two major themes, improved interpersonal relationships and improved self-regulation, both stronger than originally assumed. A more minor theme also emerged—more helpful cognitions. It is postulated that both improved interpersonal relationships and improved self-regulation are likely to enhance one another, and more helpful cognitions may express its contribution through enhanced self-regulation. These findings broaden our understanding of the impact of depression prevention programs, beginning to illuminate how such programs benefit participants. PMID:24859679

Maternal Interpersonal Trauma and Child Social-Emotional Development: An Intergenerational Effect.

PubMed

Folger, Alonzo T; Putnam, Karen T; Putnam, Frank W; Peugh, James L; Eismann, Emily A; Sa, Ting; Shapiro, Robert A; Van Ginkel, Judith B; Ammerman, Robert T

2017-03-01

Evidence suggests that maternal interpersonal trauma can adversely affect offspring health, but little is known about potential transmission pathways. We investigated whether interpersonal trauma exposure had direct and indirect associations with offspring social-emotional development at 12-months of age in an at-risk, home visited population. A retrospective cohort study was conducted of 1172 mother-child dyads who participated in a multi-site, early childhood home visiting program. Children were born January 2007 to June 2010 and data were collected at enrolment (prenatal/birth) through 12-months of age. Multivariable path analyses were used to examine the relationship between maternal interpersonal trauma, subsequent psychosocial mediators (maternal depressive symptoms, social support, and home environment), and the outcome of child social-emotional development measured with the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE). Maternal interpersonal trauma was characterized as any previous exposure, the level of exposure, and type (e.g. abuse) of exposure. The prevalence of maternal interpersonal trauma exposure was 69.1%, and exposures ranged from 1 type (19.3%) to 7 types (2.3%). Interpersonal trauma was associated with a 3.6 point (95% confidence interval 1.8, 5.4) higher ASQ:SE score among offspring and indicated greater developmental risk. An estimated 23.4% of the total effect was mediated by increased maternal depressive symptoms and lower social support. Differential effects were observed by the level and type of interpersonal trauma exposure. Maternal interpersonal trauma exposures can negatively impact child social-emotional development, acting in part through maternal psychosocial factors. Future research is needed to further elucidate the mechanisms of intergenerational risk. © 2017 John Wiley & Sons Ltd.

Trafficking and Trauma: Insight and Advice for the Healthcare System From Sex-trafficked Women Incarcerated on Rikers Island.

PubMed

Ravi, Anita; Pfeiffer, Megan R; Rosner, Zachary; Shea, Judy A

2017-12-01

Sex-trafficked persons experience significant trauma while exploited, resulting in complex health issues and barriers to health care. Incorporating survivor perspectives is critical in optimizing health care delivery for this population. We interviewed sex-trafficking survivors regarding their experiences with trauma while being trafficked and elicited advice about health care delivery. Qualitative interviews were conducted in New York City's Rikers Island jail from July to September 2015. In total, 21 English-speaking women who had experienced sex trafficking were the subjects of the study. Interview domains included: interpersonal violence, behavioral health, and health care delivery advice. Interviewees described experiencing severe and chronic trauma perpetrated by traffickers and sex buyers. Substance use was the primary method of coping with trauma. With regard to mental health, interviewees noted diagnoses of depression, anxiety and posttraumatic stress disorder, low self-esteem, and challenges in intimate relationships. Health care delivery themes included approaches to discussing trafficking in health care settings, concerns regarding sexual assault examinations, and suggestions for improving direct-services and prevention programming. With this perspective into the complex intersection of trauma and behavioral health that sex-trafficked women can experience, health care providers can better understand the context and recommendations regarding trauma-informed care practices for this population. Our results also offer several avenues for future studies with regard to discussing trafficking in clinical settings and an opportunity for stakeholders to incorporate survivor-based input to improve health care for this population.

Modeling social dimensions of oral health among older adults in urban environments.

PubMed

Metcalf, Sara S; Northridge, Mary E; Widener, Michael J; Chakraborty, Bibhas; Marshall, Stephen E; Lamster, Ira B

2013-10-01

In both developed and developing countries, population aging has attained unprecedented levels. Public health strategies to deliver services in community-based settings are key to enhancing the utilization of preventive care and reducing costs for this segment of the population. Motivated by concerns of inadequate access to oral health care by older adults in urban environments, this article presents a portfolio of systems science models that have been developed on the basis of observations from the ElderSmile preventive screening program operated in northern Manhattan, New York City, by the Columbia University College of Dental Medicine. Using the methodology of system dynamics, models are developed to explore how interpersonal relationships influence older adults' participation in oral health promotion. Feedback mechanisms involving word of mouth about preventive screening opportunities are represented in relation to stocks that change continuously via flows, as well as agents whose states of health care utilization change discretely using stochastic transitions. Agent-based implementations illustrate how social networks and geographic information systems are integrated into dynamic models to reflect heterogeneous and proximity-based patterns of communication and participation in the ElderSmile program. The systems science approach builds shared knowledge among an interdisciplinary research team about the dynamics of access to opportunities for oral health promotion. Using "what if" scenarios to model the effects of program enhancements and policy changes, resources may be effectively leveraged to improve access to preventive and treatment services. Furthermore, since oral health and general health are inextricably linked, the integration of services may improve outcomes and lower costs.

Modeling Social Dimensions of Oral Health Among Older Adults in Urban Environments

PubMed Central

Metcalf, Sara S.; Northridge, Mary E.; Widener, Michael J.; Chakraborty, Bibhas; Marshall, Stephen E.; Lamster, Ira B.

2014-01-01

In both developed and developing countries, population aging has attained unprecedented levels. Public health strategies to deliver services in community-based settings are key to enhancing the utilization of preventive care and reducing costs for this segment of the population. Motivated by concerns of inadequate access to oral health care by older adults in urban environments, this article presents a portfolio of systems science models that have been developed on the basis of observations from the ElderSmile preventive screening program operated in northern Manhattan, New York City, by the Columbia University College of Dental Medicine. Using the methodology of system dynamics, models are developed to explore how interpersonal relationships influence older adults’ participation in oral health promotion. Feedback mechanisms involving word of mouth about preventive screening opportunities are represented in relation to stocks that change continuously via flows, as well as agents whose states of health care utilization change discretely using stochastic transitions. Agent-based implementations illustrate how social networks and geographic information systems are integrated into dynamic models to reflect heterogeneous and proximity-based patterns of communication and participation in the ElderSmile program. The systems science approach builds shared knowledge among an interdisciplinary research team about the dynamics of access to opportunities for oral health promotion. Using “what if” scenarios to model the effects of program enhancements and policy changes, resources may be effectively leveraged to improve access to preventive and treatment services. Furthermore, since oral health and general health are inextricably linked, the integration of services may improve outcomes and lower costs. PMID:24084402

Relational Mindfulness for Psychiatry Residents: a Pilot Course in Empathy Development and Burnout Prevention.

PubMed

Bentley, Paige Greason; Kaplan, Sebastian G; Mokonogho, Josephine

2018-04-13

Psychiatry residents face challenges daily that test their capacity to be empathic and attuned to their own self-care. This can have a deleterious impact not only on the residents but also on patient-care. Training to manage the challenges of the work and cultivate stronger patient relationships is needed but often missing in medical education. This study aimed to pilot an empathy training course based in relational mindfulness and assess the impact on burnout and empathy. Seven first-year psychiatry residents (PGY-1) at an academic medical center in a mid-size city in the southeast participated in an eight-week pilot program created by the authors that integrated relational mindfulness and empathy training. Data were gathered from the seven PGY-1s on measures of burnout and empathy and on their experience of the training. The PGY-1s demonstrated a downward trend in means on all three burnout subscales and significant improvement on the measure of empathy (f = 8.98; p = .02). Overall, the PGY-1s reported an increased awareness of their cognitive and emotional experiences and stated that the skills learned in the program increased their ability to care for themselves, their patients, and their families. Training in intrapersonal and interpersonal attunement is often overlooked in medical training, leading to resident burnout and negative patient outcomes. An empathy course based in relational mindfulness may be a viable strategy for programs looking to attend to their residents' emotional health and bridge the empathy training gap.

Self-Efficacy and Comfort with Partner-Assisted Skin Examination in Patients Receiving Follow-Up Care for Melanoma

ERIC Educational Resources Information Center

DiMillo, J.; Brosseau, D. C.; Gomez-Garibello, C.; Hall, N. C.; Ezer, H.; Wang, B.; Körner, A.

2017-01-01

The objective of this study was to examine the role of interpersonal variables on melanoma survivors' self-efficacy for performing skin self-examinations (SSEs) during melanoma follow-up care. Specifically, the impact of comfort with partner assistance for SSE, SSE support received from one's partner, general partner support, relationship…

A Qualitative Evaluation of Elev8 New Mexico School-Based Health Centers.

PubMed

Soto Mas, Francisco; Sussman, Andrew L

There is a scarcity of qualitative studies on school-based health centers (SBHCs). We established two primary aims for this study: (a) to assess stakeholders' perceptions of Elev8 New Mexico SBHCs' functionality and (b) to provide a snapshot of the overall contribution of the program to the schools and communities they serve. We collected the data through observations and semistructured interviews. We identified issues that diminish the functionality of SBHCs, such as limited infrastructure and services, lack of cooperation between school personnel and health care providers, and lack of long-term financial sustainability. These structural, interpersonal, and logistical issues limited the contribution of the SBHCs to the health of the students and the community at large. However, Elev8 New Mexico SBHCs serve communities with considerable education and health needs and constitute a unique opportunity to provide health education, disease prevention, and quality health care to a large number of youth and adults. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Sociomoral Atmosphere in Direct-Instruction, Eclectic, and Constructivist Kindergartens: A Study of Teachers' Enacted Interpersonal Understanding.

ERIC Educational Resources Information Center

DeVries, Rheta; And Others

This study examined the interactions between teachers and children in three kindergarten classrooms. Programs used in the classrooms were: a direct-instruction (DI) program, representing a cultural transmission paradigm; a contructivist program (CON), representing the cognitive-developmental paradigm; and an eclectic program (ECL), combining…

The relationship between communication scores from the USMLE Step 2 Clinical Skills examination and communication ratings for first-year internal medicine residents.

PubMed

Winward, Marcia L; Lipner, Rebecca S; Johnston, Mary M; Cuddy, Monica M; Clauser, Brian E

2013-05-01

This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice. Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training. Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors. The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

Multimodal Education: A Model with Promise.

ERIC Educational Resources Information Center

Gerler, Edwin R., Jr.; Locke, Don C.

1980-01-01

Describes a program that uses Lazarus's factors that contribute to human growth and development as the basis for its program. The modalities covered are given the headings behavior, affect, sensation and imagery, cognition, interpersonal, and diet/physiology. (IRT)

The Chinese-version of the CARE Measure reliably differentiates between doctors in primary care: a cross-sectional study in Hong Kong

PubMed Central

2011-01-01

Background The Consultation and Relational Empathy (CARE) Measure is a widely used patient-rated experience measure which has recently been translated into Chinese and has undergone preliminary qualitative and quantitative validation. The objective of this study was to determine the reliability of the Chinese-version of the CARE Measure in reliably differentiating between doctors in a primary care setting in Hong Kong Methods Data were collected from 984 primary care patients attending 20 doctors with differing levels of training in family medicine in 5 public clinics in Hong Kong. The acceptability of the Chinese-CARE measure to patients was assessed. The reliability of the measure in discriminating effectively between doctors was analysed by Generalisability-theory (G-Theory) Results The items in the Chinese-CARE measure were regarded as important by patients and there were few 'not applicable' responses. The measure showed high internal reliability (coefficient 0.95) and effectively differentiated between doctors with only 15-20 patient ratings per doctor (inter-rater reliability > 0.8). Doctors' mean CARE measure scores varied widely, ranging from 24.1 to 45.9 (maximum possible score 50) with a mean of 34.6. CARE Measure scores were positively correlated with level of training in family medicine (Spearman's rho 0.493, p < 0.05). Conclusion These data demonstrate the acceptability, feasibility and reliability of using the Chinese-CARE Measure in primary care in Hong Kong to differentiate between doctors interpersonal competencies. Training in family medicine appears to enhance these key interpersonal skills. PMID:21631927

The effects of physician communications skills on patient satisfaction; recall, and adherence.

PubMed

Bartlett, E E; Grayson, M; Barker, R; Levine, D M; Golden, A; Libber, S

1984-01-01

An understanding of means to improve patient adherence to the therapeutic regimen is a subject of increasing concern in medical care. This study examined the effects of physician interpersonal skills and teaching on patient satisfaction, recall, and adherence to the regimen. We studied the ambulatory visits of 63 patients to five medical residents at a teaching hospital in Baltimore. It was found that quality of interpersonal skills influenced patient outcomes more than quantity of teaching and instruction. Secondary analyses found that all the effects of physician communication skills on patient adherence are mediated by patient satisfaction and recall. These findings indicate that the physician might pay particular attention to these two variables in trying to improve patient adherence, and that enhancing patient satisfaction may be pivotal to the care of patients with chronic illness.

[Parents and nursing staff's expectations regarding the nurse's work in a NICU].

PubMed

Kamada, Ivone; Rocha, Semíramis Melani Melo

2006-09-01

The general purpose of this investigation was to identify parent and nursing staff expectations regarding the nurse's role in Neonatal Intensive Care Units (NICU). A descriptive study was carried out using a qualitative approach and interviews were conducted at a NICU in the interior of the State of São Paulo. Results showed new expectations on the part of parents and professionals regarding the role of NICU nurses. The knowledge identified as necessary were a family-centered approach, interpersonal relations techniques, and differentiation between technology and scientific knowledge. The conclusion is that NICU nurses need to play a more incisive role in the nursing care process, adjusting the use of technological advances to human knowledge, particularly in the area of interpersonal relationships between family members and staff, which includes activities of continuing education, such as specialization courses.

How personal and standardized coordination impact implementation of integrated care.

PubMed

Benzer, Justin K; Cramer, Irene E; Burgess, James F; Mohr, David C; Sullivan, Jennifer L; Charns, Martin P

2015-10-02

Integrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care. Semi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations. Interviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures. This study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation. Integrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.

Psychological and interpersonal adaptation to Mars missions

NASA Technical Reports Server (NTRS)

Harrison, A. A.; Connors, M. M.

1985-01-01

The crucial importance of a thorough understanding of the psychological and interpersonal dimensions of Mars flights is indicated. This is necessary both to reduce the chances that psychological problems or interpersonal frictions will threaten the success of Mars missions and to enhance the quality of life of the people involved. Adaptation to interplanetary flight will depend on an interplay of the psychological stresses imposed by the missions and the psychological strengths and vulnerabilities of the crewmembers involved. Stresses may be reduced through environmental engineering, manipulating crew composition, and the structuring of situations and tasks. Vulnerabilities may be reduced through improving personnel selection procedures, training personnel in psychological and group dynamics, and providing mechanisms for emotional support. It is essential to supplement anecdotal evidence regarding the human side of space travel with the results of carefully conducted scientific research.

Training: more user friendly.

PubMed

Horibe, N

1994-03-01

China launched its family planning program in 1971 by initially focusing on public information campaigns and providing services to married couples nationwide. It eventually instituted programs to improve maternal and child health/family planning (MCH/FP) through better quality service. Such programs introduced interpersonal communication and counseling to improve quality service. In 1990, with help from UNICEF and the United Nations Population Fund [UNFPA], the Ministry of Public Health (MOPH) implemented a project to improve MCH/FP in 300 of China's poorest counties. Its training activities are chiefly for physicians and emphasize safe motherhood, breast feeding, diarrhea, case management of acute respiratory infection, and FP. Interpersonal communication and counseling has been included in each of these areas. Also with UNFPA assistance, the State Family Planning Commission (SFPC) began a project in 1991, targeting township and village family planning workers, which concentrates on interpersonal communication and counseling in its service delivery system. MOPH and SFPC are China's 2 vertical service delivery systems and they do not cooperate at the central level. At the lower level, however, they work together in interpersonal communication and counseling training. The training uses the participatory training method, which encourages two-way communication. The curriculum addresses motivation; education and counseling; perception, values, and misconceptions; verbal and nonverbal communications; interviewing and listening skills; and how to help the client's decision making. Feedback is very important. The participatory method training class should not exceed 50 participants, but financial constraints make this difficult in China. Short-term benefits of the training are: inspiration to trainers, increased sensitivity to the clients' needs and feelings, and exposure to an international professional work ethic and practice.

Measuring The Impact Of Cash Transfers And Behavioral 'Nudges' On Maternity Care In Nairobi, Kenya.

PubMed

Cohen, Jessica; Rothschild, Claire; Golub, Ginger; Omondi, George N; Kruk, Margaret E; McConnell, Margaret

2017-11-01

Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted. The second was a cash transfer that combined labeling and a commitment by the recipient to deliver in a prespecified desired facility as a condition of receiving the final payment (L-CCT). The L-CCT improved patient-perceived quality of interpersonal care but not perceived technical quality of care. It also increased women's likelihood of delivering in facilities that met standards for routine and emergency newborn care but not the likelihood of delivering in facilities that met standards for obstetric care. The LCT had fewer measured benefits. Women preferred facilities with high technical and interpersonal care quality, but these quality measures were often negatively correlated within facilities. Even with cash transfers, many women still used poor-quality facilities. A larger study is warranted to determine whether the L-CCT can improve maternal and newborn outcomes.

"Tell, tell, tell again": The prevalence and correlates of young children's response to and disclosure of an in-vivo lure from a stranger.

PubMed

White, Codi; Shanley, Dianne C; Zimmer-Gembeck, Melanie J; Walsh, Kerryann; Hawkins, Russell; Lines, Katrina

2018-06-11

Despite being a key target outcome to prevent child maltreatment, little research has been conducted to examine the prevalence and predictors of interpersonal safety skills in a standardised manner. In this study, interpersonal safety skills were measured in a Year 1-2 student sample through use of a standardised simulated risk scenario, with three primary skills examined: withdrawal from an unknown confederate (motor safety response), verbal refusal of an abduction lure (verbal safety response) and disclosure of confederate presence. Children who participated in this study had not completed any prior behavioural skills training or child protective education programs. Overall, the prevalence of interpersonal safety skills varied, with 27% children withdrawing from the confederate, 48% refusing the lure and 83% disclosing the confederate's presence. For correlates, motor and verbal safety responses were positively associated with each other. However, the only other correlate of interpersonal safety skills was anxiety, with children who had greater anxiety disclosing earlier but also being more likely to agree to leave with the confederate. Future research may seek to examine whether these correlates remain present with different types of interpersonal safety risk (e.g., bullying) and to identify other potential predictors of interpersonal safety skill use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Interpersonal skills development in Generation Y student nurses: a literature review.

PubMed

Bhana, Varshika M

2014-12-01

Student nurses require training in the development of the interpersonal skills that are required for therapeutic nurse-patient relationships. This training should be provided within the basic education of nurses in a higher education institution. As the birth years of Generation Y range from the early 1980s to the late 1990s this generation is of the age group that enrols in higher education institutions. The unique learning needs of this generation necessitate a review of teaching strategies used in the development of interpersonal skills. The aim of this study is to present a literature review on the significance and development of interpersonal skills in Generation Y nursing students through nursing education. Literature searches were conducted on databases-with the use of Cumulative Index of Nursing and Allied Health (CINAHL), Clinical key, PubMed and Google Scholar-using specific keywords and a timeframe of 2005 to 2013. All relevant articles were read critically. Interpersonal skills are at the core of the nurse-patient relationship. Meaningful interaction is recognised in Swanson's theory of "informed caring". Debates, case studies, role-playing, storytelling, journaling, simulations and web page links to audio and video clips are some of the teaching strategies which can develop the interpersonal skills needed for meaningful interactions. Teaching strategies embedded in the deconstruction pedagogies stimulate critical, analytical thinking through methods which complement the unique learning styles of Generation Y learners. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emotional Intelligence and the ACGME Competencies.

PubMed

Webb, Anita R; Young, Richard A; Baumer, Joane G

2010-12-01

Residency programs desire assessment tools for teaching and measuring resident attainment of the Accreditation Council for Graduate Medical Education competencies, including interpersonal and communication skills. We sought to evaluate the use of emotional intelligence (EI) assessment and training tools in assessing and enhancing interpersonal and communication skills. We used a quasi-experimental design, with an intervention and control group composed of 1 class each of family medicine residents. The intervention was EI coaching. The assessment used the Emotional and Social Competence Inventory, a 360-degree EI survey consisting of self and other (colleague) ratings for 12 EI competencies. There were 21 participants in each of the 3 assessments (test, posttest, and control). Our EI coaching intervention had very limited participation due to a lack of protected time for EI coaching and residents' competing obligations. Return rates for self surveys were 86% to 91% and 66% to 68% for others. On all 3 trials, ratings by others were significantly higher than self ratings for every competence (range, P < .001-.045). None of the self ratings by the intervention group increased significantly for any of the competencies. None of the intervention group self ratings increased significantly on posttesting, whereas ratings by others increased significantly for coach/mentor (P < .001). The teamwork rating decreased significantly on both self and other ratings (P < .001). Achievement orientation was the highest intervention group posttest rating, and teamwork was the lowest. EI is a necessary skill in today's health care environment, and our study found that a tool from another sector was useful in assessing resident EI skills. Because our EI coaching intervention was unsuccessful, the effects of coaching on interpersonal and communication skills could not be assessed.

Making sense of effective partnerships among senior leaders in the National Health Service.

PubMed

Mitra, Mahima; Hoff, Timothy; Brankin, Paul; Dopson, Sue

2017-05-22

Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions. We conducted 24 in-depth interviews with physician and nonphysician leaders in job titles including Chief Operating Officer, Managing Director, Medical Director, and Clinical Director. Ideas from the social psychological perspectives of sensemaking, organizational role theory, and organizational citizenship behavior helped frame the study. We identified four areas of ongoing tension between senior leaders. Each of these was linked to a set of underlying drivers, with the strongest support for drivers with interpersonal roots. Effective strategies for resolving tensions involved significant effort by leaders at improving the interpersonal dynamics associated with everyday interaction and forging relational connections through enhanced trust within the leadership team. This study outlines the organizational and individual characteristics that lend to effective collaboration among senior health care leadership and the types of collaborative tensions likely to be experienced by senior health care leaders. Organizations should provide greater role clarity for senior leadership roles, promote "soft" interpersonal competencies within them, and better assess potential leaders for success in senior roles. Organizational support in the form of facilitation, time, and spaces to learn together can provide a better context for collaborative decision-making.

Tai-Chi for Residential Patients with Schizophrenia on Movement Coordination, Negative Symptoms, and Functioning: A Pilot Randomized Controlled Trial

PubMed Central

Ho, Rainbow T. H.; Au Yeung, Friendly S. W.; Lo, Phyllis H. Y.; Law, Kit Ying; Wong, Kelvin O. K.; Cheung, Irene K. M.; Ng, Siu Man

2012-01-01

Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia. Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi. Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services. PMID:23304224

Tai-chi for residential patients with schizophrenia on movement coordination, negative symptoms, and functioning: a pilot randomized controlled trial.

PubMed

Ho, Rainbow T H; Au Yeung, Friendly S W; Lo, Phyllis H Y; Law, Kit Ying; Wong, Kelvin O K; Cheung, Irene K M; Ng, Siu Man

2012-01-01

Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia. Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention. Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi. Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services.

Complex Mental Health Sequelae of Psychological Trauma Among Women in Prenatal Care

PubMed Central

Seng, Julia S.; D’Andrea, Wendy; Ford, Julian D.

2014-01-01

Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically significant dissociation, somatization, or affect dysregulation. Six sub-groups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were over-represented in four sub-groups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse), (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse), (3) somatization (adult abuse), and (4) GAD (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity. PMID:25558308

Interpersonal Conflict and Organizational Commitment Among Licensed Practical Nurses.

PubMed

Loes, Chad N; Tobin, Mary B

The shortage of nursing professionals in the United States is unquestionable. This shortage, which is predicted to continue into the foreseeable future, is a particularly salient problem within the nursing profession. This is especially true for long-term care facility administrators who not only are faced with the challenge of increasing numbers of aging residents but also regularly struggle with turnover among more cost-effective nursing staff, such as licensed practical nurses (LPNs). The primary purpose of this study was to examine whether perceived interpersonal conflict influences organizational commitment among LPNs. To accomplish this, we analyzed responses from 1165 LPNs throughout a Midwestern state who were queried on their perceptions of interpersonal conflict and organizational commitment in their work settings. Considering a wide range of potential confounding influences such as age and years working as an LPN, for example, we found that higher perceived interpersonal conflict was associated with significantly lower levels of organizational commitment. The implications of these findings, along with recommendations for nurse administrators to reduce LPN turnover, are discussed in the article.

An in-depth mixed-methods approach to Ryan White HIV/AIDS care program comprehensive needs assessment from the Northeast Georgia Public Health District: the significance of patient privacy, psychological health, and social stigma to care.

PubMed

Huff, Amber; Chumbler, Neale; Cherry, Colleen O'Brien; Hill, Miranda; Veguilla, Vic

2015-04-01

We apply a social-ecological interpretive framework to understanding relationships among patient privacy, psychological health, social stigma, and continuity in care in the HIV treatment cascade in the rural southeastern US. This research was conducted as part of the 2013 comprehensive needs assessment for the Northeast Georgia Ryan White Consortium using an anthropologically informed mixed-methods design, and a deductive-inductive approach to thematic analysis of qualitative data obtained in interviews and focus groups with service providers and service utilizers. Our comprehensive needs assessment yielded two key components. First, we identified salient phenomena influencing introduction to, retention among, and satisfaction of patients in the Ryan White-coordinated treatment cascade in NE-GA. Second, we formulated actionable recommendations around leverage points identified in the current district-wide system of care. Results highlight spatial, institutional, and interpersonal aspects of the system of care that intersect around issues of patient privacy, psychological health, and social stigma. These intersections constitute pathways by which persons living with HIV are exposed to stigma and other negative social signals regarding their health status without sufficient access to behavioral health services. These negative issues, in turn, can erect significant barriers to long-term continuity in care. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inverse roles of emotional labour on health and job satisfaction among long-term care workers in Japan.

PubMed

Tsukamoto, Erika; Abe, Takeru; Ono, Michikazu

2015-01-01

Emotional labour increases among long-term care workers because providing care and services to impaired elders causes conflicting interpersonal emotions. Thus, we investigated the associations between emotional labour, general health and job satisfaction among long-term care workers. We conducted a cross-sectional study among 132 established, private day care centres in Tokyo using a mail survey. The outcome variables included two health-related variables and four job satisfaction variables: physical and psychological health, satisfaction with wages, interpersonal relationships, work environment and job satisfaction. We performed multiple regression analyses to identify significant factors. Directors from 36 facilities agreed to participate. A total of 123 responses from long-term care workers were analysed. Greater emotional dissonance was associated with better physical and psychological health and worse work environment satisfaction (partial regression coefficient: -2.93, p = .0389; -3.32, p = .0299; -1.92, p = .0314, respectively). Fewer negative emotions were associated with more job satisfaction (partial regression coefficient: -1.87, p = .0163). We found that emotional labour was significantly inversely associated with health and job satisfaction. Our findings indicated that the emotional labour of long-term care workers has a negative and positive influence on health and workplace satisfaction, and suggests that care quality and stable employment among long-term care workers might affect their emotional labour. Therefore, we think a programme to support emotional labour among long-term care workers in an organized manner and a self-care programme to educate workers regarding emotional labour would be beneficial.

"One Problem Became Another": Disclosure of Rape-Related Pregnancy in the Abortion Care Setting.

PubMed

Perry, Rachel; Murphy, Molly; Haider, Sadia; Harwood, Bryna

2015-01-01

We sought to explore the experiences of women who disclosed that their pregnancies resulted from rape in the abortion care setting, as well as the experiences of professionals involved in care of women with rape-related pregnancy. In-depth interviews were conducted with 9 patients who had terminated rape-related pregnancies and 12 professionals working in abortion care or rape crisis advocacy (5 abortion providers, 4 rape crisis center advocates, 2 social workers, and 1 clinic administrator). Transcribed interviews were coded and analyzed for themes related to the experiences of disclosing rape and the consequences of disclosure in the abortion care setting. Patients and professionals involved in care of women with rape-related pregnancy described opportunities arising from disclosure, including interpersonal (explaining abortion decision making in the context of assault, belief, and caring by providers), as well as structural opportunities (funding assistance, legal options, and mental health options). Whereas most patients did not choose to pursue all three structural opportunities, both patients and professionals emphasized the importance of offering them. The most important consequence of disclosure for patients was being believed and feeling that providers cared about them. Rape-related pregnancy disclosure in the abortion care setting can lead to opportunities for interpersonal support and open options for funding, legal recourse, and mental health care. Those working in abortion care should create environments conducive to disclosure and opportunities for rape survivors to access these additional options if they desire. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Early Head Start Relationships: Association with Program Outcomes

ERIC Educational Resources Information Center

Elicker, James; Wen, Xiaoli; Kwon, Kyong-Ah; Sprague, Jill B.

2013-01-01

Research Findings: Interpersonal relationships among staff caregivers, parents, and children have been recommended as essential aspects of early childhood intervention. This study explored the associations of these relationships with program outcomes for children and parents in 3 Early Head Start programs. A total of 71 children (8-35 months,…

The Influence of Social Intelligence on Effective Music Teaching

ERIC Educational Resources Information Center

Juchniewicz, Jay

2010-01-01

The purpose of this study was to investigate the influence of social intelligence on effective music teaching. Forty teachers from "exemplary programs" and "more challenging programs" across band, chorus, orchestra, and general public school music programs were administered the Interpersonal Perception Task-15 (IPT-15). In addition, 84 external…

DYAD: A Computer Program for the Analysis of Interpersonal Communication

ERIC Educational Resources Information Center

Fogel, Daniel S.

1978-01-01

A computer program which generates descriptions of conversational patterns of dyads based on sound-silence data is described. Input consists of talk/no-talk designations; output consists of descriptive matrices, histograms, and individual talk parameters. (Author/JKS)

[Development of Empowerment Program for Persons with Chronic Mental Illness and Evaluation of Impact].

PubMed

Kim, Mijung; Lee, Kyunghee

2015-12-01

This study was done to develop an empowerment program for people with chronic mental illness and to analyze effects of the program on level of empowerment. The research was conducted using a nonequivalent control group pretest-posttest design. Participants were 37 people with chronic mental illness (experimental group: 18, control group: 19). The empowerment program was provided for 8 weeks (15 sessions). Data were collected between July 21 and October 17, 2014. Data were analyzed using Chi-square, Fisher's exact test, Sapiro-Wilk test, and Repeated measure ANOVA with SPSS/WIN 18.0. Quantitative results show that self-efficacy, interpersonal relationships, attitudes in the workplace, occupational performance capacity, and levels of empowered execute were significantly better in the experimental group compared to the control group. Study findings indicate that this empowerment program for persons with chronic mental illness is effective for improving self efficacy, interpersonal skills, attitudes in the workplace, occupational performance capacity, levels of empowered execute.

Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland.

PubMed

Mander, Sarah; Miller, Yvette D

2016-03-01

Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

Preparing the Communication Specialist: Some Implications of an Ongoing "Train the Trainer" Program in One Industry.

ERIC Educational Resources Information Center

Shaw, Mark R.; Caplette, Michele

Interviews with six managers trained to teach the Interpersonal Managing Skills (IMS) program at the Lockheed Missiles and Space Company provided insights into three aspects of communication training programs: training skills, the trainer role, and methods of training the trainer. A highly structured, packaged program, IMS teaches five…

Self-reported financial burden and satisfaction with care among patients with cancer.

PubMed

Chino, Fumiko; Peppercorn, Jeffrey; Taylor, Donald H; Lu, Ying; Samsa, Gregory; Abernethy, Amy P; Zafar, S Yousuf

2014-04-01

Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ≥ 21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ≥ 1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale. Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: -.29), satisfaction with technical quality (coefficient: -.26), and satisfaction with financial aspects of care (coefficient: -.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor. FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life.

Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations with staff during clinical placement: A qualitative study.

PubMed

McCloughen, Andrea; Foster, Kim

2018-07-01

To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations. Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences and development of effective relationships. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations is not well known. A qualitative design, using semi-structured interviews to explore experiences of challenging interpersonal situations during clinical placement (Phase two of a larger mixed-methods study). Final-year Australian university nursing and pharmacy students (n = 20) were purposefully recruited using a range of Emotional Intelligence scores (derived in Phase one), measured using the GENOS Emotional intelligence Inventory (concise version). Challenging interpersonal situations involving student-staff and intrastaff conflict, discourteous behaviour and criticism occurred during clinical placement. Students used personal and relational strategies, incorporating emotionally intelligent behaviours, to manage these encounters. Strategies included reflecting and reframing, being calm, controlling discomfort and expressing emotions appropriately. Emotionally intelligent behaviours are effective to manage stressful interpersonal interactions. Methods for strengthening these behaviours should be integrated into education of nursing and pharmacy students and qualified professionals. Education within the clinical/workplace environment can incorporate key interpersonal skills of collaboration, social interaction and reflection, while also attending to sociocultural contexts of the healthcare setting. Students and staff are frequently exposed to stressful clinical environments and challenging interpersonal encounters within healthcare settings. Use of emotionally intelligent behaviours to recognise and effectively manage these encounters may contribute to greater stress tolerance and enhanced professional relationships. Nursing and pharmacy students, and their qualified counterparts, need to be educated to strengthen their emotional intelligence skills. © 2017 John Wiley & Sons Ltd.

Duty Hour Recommendations and Implications for Meeting the ACGME Core Competencies: Views of Residency Directors

PubMed Central

Antiel, Ryan M.; Thompson, Scott M.; Hafferty, Frederic W.; James, Katherine M.; Tilburt, Jon C.; Bannon, Michael P.; Fischer, Philip R.; Farley, David R.; Reed, Darcy A.

2011-01-01

OBJECTIVE: To describe the views of residency program directors regarding the effect of the 2010 duty hour recommendations on the 6 core competencies of graduate medical education. METHODS: US residency program directors in internal medicine, pediatrics, and general surgery were e-mailed a survey from July 8 through July 20, 2010, after the 2010 Accreditation Council for Graduate Medical Education (ACGME) duty hour recommendations were published. Directors were asked to rate the implications of the new recommendations for the 6 ACGME core competencies as well as for continuity of inpatient care and resident fatigue. RESULTS: Of 719 eligible program directors, 464 (65%) responded. Most program directors believe that the new ACGME recommendations will decrease residents' continuity with hospitalized patients (404/464 [87%]) and will not change (303/464 [65%]) or will increase (26/464 [6%]) resident fatigue. Additionally, most program directors (249-363/464 [53%-78%]) believe that the new duty hour restrictions will decrease residents' ability to develop competency in 5 of the 6 core areas. Surgery directors were more likely than internal medicine directors to believe that the ACGME recommendations will decrease residents' competency in patient care (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.5-6.3), medical knowledge (OR, 1.9; 95% CI, 1.2-3.2), practice-based learning and improvement (OR, 2.7; 95% CI, 1.7-4.4), interpersonal and communication skills (OR, 1.9; 95% CI, 1.2-3.0), and professionalism (OR, 2.5; 95% CI, 1.5-4.0). CONCLUSION: Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation. PMID:21307391

Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

PubMed

Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela

2017-07-14

Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of professional challenges can, in turn, improve professional development, which is essential for high quality patient care.

Psychometric validation and reliability analysis of a Spanish version of the patient satisfaction with cancer-related care measure: a patient navigation research program study.

PubMed

Jean-Pierre, Pascal; Fiscella, Kevin; Winters, Paul C; Paskett, Electra; Wells, Kristen; Battaglia, Tracy

2012-09-01

Patient satisfaction (PS), a key measure of quality of cancer care, is a core study outcome of the multi-site National Cancer Institute-funded Patient Navigation Research Program. Despite large numbers of underserved monolingual Spanish speakers (MSS) residing in USA, there is no validated Spanish measure of PS that spans the whole spectrum of cancer-related care. The present study reports on the validation of the Patient Satisfaction with Cancer Care (PSCC) measure for Spanish (PSCC-Sp) speakers receiving diagnostic and therapeutic cancer-related care. Original PSCC items were professionally translated and back translated to ensure cultural appropriateness, meaningfulness, and equivalence. Then, the resulting 18-item PSCC-Sp measure was administered to 285 MSS. We evaluated latent structure and internal consistency of the PSCC-Sp using principal components analysis (PCA) and Cronbach coefficient alpha (α). We used correlation analyses to demonstrate divergence and convergence of the PSCC-Sp with a Spanish version of the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I-Sp) measure and patients' demographics. The PCA revealed a coherent set of items that explicates 47% of the variance in PS. Reliability assessment demonstrated that the PSCC-Sp had high internal consistency (α = 0.92). The PSCC-Sp demonstrated good face validity and convergent and divergent validities as indicated by moderate correlations with the PSN-I-Sp (p = 0.003) and nonsignificant correlations with marital status and household income (all p(s) > 0.05). The PSCC-Sp is a valid and reliable measure of PS and should be tested in other MSS populations.

Powerlessness, marginalized identity, and silencing of health concerns: voiced realities of women living with a mental health diagnosis.

PubMed

Van Den Tillaart, Susan; Kurtz, Donna; Cash, Penny

2009-06-01

Using a feminist qualitative approach, this study substantiated many earlier research findings that document how women with a mental health diagnosis experience unequal access to comprehensive health care compared to the general population. Accounts of this disparity are documented in the literature, yet the literature has failed to record or attend to the voices of those living with mental health challenges. In this paper, women living with a mental health diagnosis describe their experiences as they interface with the health-care system. The participating women's stories clearly relate the organizational and interpersonal challenges commonly faced when they seek health-care services. The stories include experiences of marginalized identity, powerlessness, and silencing of voiced health concerns. The women tell of encountered gaps in access to health care and incomplete health assessment, screening, and treatment. It becomes clear that personal and societal stigmatization related to the mental health diagnosis plays a significant role in these isolating and unsatisfactory experiences. Lastly, the women offer beginning ideas for change by suggesting starting points to eliminate the institutional and interpersonal obstacles or barriers to their wellness. The concerns raised demand attention, reconsideration, and change by those in the health-care system responsible for policy and practice.

Bullying, harassment, and horizontal violence in the nursing workforce: the state of the science.

PubMed

Vessey, Judith A; Demarco, Rosanna; DiFazio, Rachel

2010-01-01

In the complex health care workplace of nurses, intra/interprofessional ideals intersect with the expectations of patients, families, students, and coworkers in a context of managed care environments, academia, and other health care enterprises. Integral to quality assessment, management, and assurance is collegial and respectful communication. Decades of reported descriptive and anecdotal data on intra/inter professional and on client communication, describe the antithesis of these ideals. Specifically, increasing frequency and rates of persistent bullying, harassment, or horizontal violence (BHHV) have shown to yield detrimental effects on workplace satisfaction, workforce retention, and the psychological and physical health of nurses as well as implied effects on quality of patient care and risk of poor health outcomes. Persistent BHHV among nurses is a serious concern. In advancing the science of description and explanation to a level of prevention intervention, explanatory models from biology, developmental psychology, intra/interpersonal interactionism are described along with theoretical explanations for the prevalence of BHHV in nurse workplaces. Making the connection between explanatory models and creative solutions to address BHHV through multiple levels of behavioral influence such as individual, environmental, interpersonal, and cultural contexts is key to advancing the science of the relationship between professional behavior and client/family/community health care outcomes.

[Differences in attitude toward patient-centeredness in patients and physicians].

PubMed

Kim, Min-Jeong

2013-06-01

There have been studies on the patient-centeredness of medical students and physicians in South Korea, but no result has presented the patient-centered attitude of patients and doctors. So, this study intended to compare the attitudes of patients and doctors toward the roles that patients and physicians should play in the health care process. One hundred and fifteen doctors and 264 patients participated in this survey using a structured questionnaire, including sociodemographic data and Patient Practitioner Orientation Scale (PPOS). The PPOS comprises sharing (sharing information, take part in decision making) and caring (respecting one's feelings, interpersonal relationships) subscales. The PPOS scores of the doctors and patient were 3.02 and 3.20. In detail, the doctors' sharing and caring scores were and 3.02 and 3.48, and the those of patients were 3.14 and 3.12, respectively. This results are enough to demonstrate that patients are likely to be patient-centered with regard to sharing and that doctors tend to be patient-centered in terms of caring. The patients' desire to obtain medical information and take part in decision making (sharing) are greater than those of doctors. Doctors had more patient-centered attitude than patients in terms of respects for one's feelings and interpersonal relationships (caring).

Understanding African Americans' Views of the Trustworthiness of Physicians

PubMed Central

Jacobs, Elizabeth A; Rolle, Italia; Ferrans, Carol Estwing; Whitaker, Eric E; Warnecke, Richard B

2006-01-01

BACKGROUND Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. OBJECTIVE To better understand what trust and distrust in physicians means to African Americans. DESIGN Focus-group study, using an open-ended discussion guide. SETTING Large public hospital and community organization in Chicago, IL. PATIENTS Convenience sample of African-American adult men and women. MEASUREMENTS Each focus group was systematically coded using grounded theory analysis. The research team then identified themes that commonly arose across the 9 focus groups. RESULTS Participants indicated that trust is determined by the interpersonal and technical competence of physicians. Contributing factors to distrust in physicians include a lack of interpersonal and technical competence, perceived quest for profit and expectations of racism and experimentation during routine provision of health care. Trust appears to facilitate care-seeking behavior and promotes patient honesty and adherence. Distrust inhibits care-seeking, can result in a change in physician and may lead to nonadherence. CONCLUSIONS Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans. PMID:16808750

Rethinking the Concept of Sustainability: Hiroshima as a Subject of Peace Education

ERIC Educational Resources Information Center

Ide, Kanako

2017-01-01

The article discusses a sustainable educational approach for developing a moral value of peace by using a historical event, the bombing of Hiroshima. To make the case, the article uses the care theory of Nel Noddings to discuss the interpersonal aspects of peace education. The article asks how care theory handles tragedies like Hiroshima and it…

The Association between the Working Alliance with Adolescent Girls in Residential Care and Their Trauma-Related Symptoms in Emerging Adulthood

ERIC Educational Resources Information Center

Ayotte, Marie-Hélène; Lanctôt, Nadine; Tourigny, Marc

2017-01-01

Background: Until now, the relations between the working alliance and trauma-related symptoms have received little or no study in residential-care settings. However, considering the high prevalence of past experiences of interpersonal trauma among young people in residential centers, it is essential to examine this issue more closely. Objective:…

[Definition of medical competence. The point of view of chronically-ill patients in the Andalusian public healthcare system (Spain)].

PubMed

Prieto Rodríguez, M Ángeles; Danet Danet, Alina; Escudero Carretero, María J; Ruiz Azarola, Ainhoa; Pérez Corral, Olivia; García Toyos, Noelia

2012-01-01

To identify the attributes used by chronically-ill patients to describe physicians' competence in the public healthcare system in Andalucia. A total of 147 chronically-ill patients and their relatives were included in this qualitative study. Focal groups and in-depth interviews were performed in health centers and outpatient centers in Granada, Malaga, Seville, Cadiz and Cordoba between 2007 and 2008. Content analysis was carried out using Nudist Vivo. The participants defined medical competence as combining elements of technical ability and knowledge (awareness of and interest in the disease, continuity of follow-up and requesting specific tests) with interpersonal skills related to communication, information (informing, listening, trust, prompting questions) and attention (courtesy, cordiality, respect, interest and approachability). Primary care was expected to provide a close relationship, personalized treatment, information, drug prescription, and referral to specialized care. Specialized care was expected to provide an accurate diagnosis and appropriate treatment, information and follow-up. Highly valued aspects of emergency care were symptom relief, accurate diagnosis, referral to specialists and courtesy. Chronically-ill patients based their evaluation of medical competence on technical and interpersonal skills. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

"Attention on the flight deck": what ambulatory care providers can learn from pilots about complex coordinated actions.

PubMed

Frankel, Richard M; Saleem, Jason J

2013-12-01

Technical and interpersonal challenges of using electronic health records (EHRs) in ambulatory care persist. We use cockpit communication as an example of highly coordinated complex activity during flight and compare it with providers' communication when computers are used in the exam room. Maximum variation sampling was used to identify two videotapes from a parent study of primary care physicians' exam room computer demonstrating the greatest variation. We then produced and analyzed visualizations of the time providers spent looking at the computer and looking at the patient. Unlike the cockpit which is engineered to optimize joint attention on complex coordinated activities, we found polar extremes in the use of joint focus of attention to manage the medical encounter. We conclude that there is a great deal of room for improving the balance of interpersonal and technical attention that occurs in routine ambulatory visits in which computers are present in the exam room. Using well-known aviation practices can help primary care providers become more aware of the opportunities and challenges for enhancing the physician patient relationship in an era of exam room computing. Published by Elsevier Ireland Ltd.

Turnover in health care: the mediating effects of employee engagement.

PubMed

Collini, Stevie A; Guidroz, Ashley M; Perez, Lisa M

2015-03-01

This study aimed to understand the interaction between interpersonal respect, diversity climate, mission fulfilment and engagement to better predict turnover in health care. Registered nurse turnover has averaged 14% and current nursing shortages are expected to spread. Few studies have studied employee engagement as a mediator between organisational context and turnover. Study participants were employees working within 185 departments across ten hospitals within a large healthcare organisation in the USA. Although a total of 5443 employees work in these departments, employee opinion survey responses were aggregated by department before being linked to turnover rates gathered from company records. Engagement fully mediated the relationship between respect and turnover and the relationship between mission fulfilment and turnover. Diversity climate was not related to turnover. Turnover in health care poses a significant threat to the mission of creating a healing environment for patients and these results demonstrate that workplace respect and connection to the mission affect turnover by decreasing engagement. The findings demonstrated that to increase engagement, and improve turnover rates in health care, it would be beneficial for organisations, and nurse management to focus on improving mission fulfilment and interpersonal relationships. © 2013 John Wiley & Sons Ltd.

Development of a monitoring instrument to assess the performance of the Swiss primary care system.

PubMed

Ebert, Sonja T; Pittet, Valérie; Cornuz, Jacques; Senn, Nicolas

2017-11-29

The Swiss health system is customer-driven with fee-for-service paiement scheme and universal coverage. It is highly performing but expensive and health information systems are scarcely implemented. The Swiss Primary Care Active Monitoring (SPAM) program aims to develop an instrument able to describe the performance and effectiveness of the Swiss PC system. Based on a Literature review we developed a conceptual framework and selected indicators according to their ability to reflect the Swiss PC system. A two round modified RAND method with 24 inter-/national experts took place to select primary/secondary indicators (validity, clarity, agreement). A limited set of priority indicators was selected (importance, priority) in a third round. A conceptual framework covering three domains (structure, process, outcome) subdivided into twelve sections (funding, access, organisation/ workflow of resources, (Para-)Medical training, management of knowledge, clinical-/interpersonal care, health status, satisfaction of PC providers/ consumers, equity) was generated. 365 indicators were pre-selected and 335 were finally retained. 56 were kept as priority indicators.- Among the remaining, 199 were identified as primary and 80 as secondary indicators. All domains and sections are represented. The development of the SPAM program allowed the construction of a consensual instrument in a traditionally unregulated health system through a modified RAND method. The selected 56 priority indicators render the SPAM instrument a comprehensive tool supporting a better understanding of the Swiss PC system's performance and effectiveness as well as in identifying potential ways to improve quality of care. Further challenges will be to update indicators regularly and to assess validity and sensitivity-to-change over time.

Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services.

PubMed

Price, Sarah Kye; Coles, D Crystal; Wingold, Tracey

2017-11-01

Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs. © 2017 National Association of Social Workers.

Problems, Perplexities, and Politics of Program Evaluation.

ERIC Educational Resources Information Center

Schneider, Gail Thierbach

All educational evaluations share common problems, perplexities, and political considerations. Logistic problems include incomplete definition of purpose, unclear timelines and personnel allocations, inadequate support services, and the lack of a program plan. Interpersonal dynamics and conflicts plus unwieldy committee structures are perplexities…

Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control.

PubMed

English, Krista M; Langley, Joanne M; McGeer, Allison; Hupert, Nathaniel; Tellier, Raymond; Henry, Bonnie; Halperin, Scott A; Johnston, Lynn; Pourbohloul, Babak

2018-04-17

Nosocomial, or healthcare-associated infections (HAI), exact a high medical and financial toll on patients, healthcare workers, caretakers, and the health system. Interpersonal contact patterns play a large role in infectious disease spread, but little is known about the relationship between health care workers' (HCW) movements and contact patterns within a heath care facility and HAI. Quantitatively capturing these patterns will aid in understanding the dynamics of HAI and may lead to more targeted and effective control strategies in the hospital setting. Staff at 3 urban university-based tertiary care hospitals in Canada completed a detailed questionnaire on demographics, interpersonal contacts, in-hospital movement, and infection prevention and control practices. Staff were divided into categories of administrative/support, nurses, physicians, and "Other HCWs" - a fourth distinct category, which excludes physicians and nurses. Using quantitative network modeling tools, we constructed the resulting HCW "co-location network" to illustrate contacts among different occupations and with locations in hospital settings. Among 3048 respondents (response rate 38%) an average of 3.79, 3.69 and 3.88 floors were visited by each HCW each week in the 3 hospitals, with a standard deviation of 2.63, 1.74 and 2.08, respectively. Physicians reported the highest rate of direct patient contacts (> 20 patients/day) but the lowest rate of contacts with other HCWs; nurses had the most extended (> 20 min) periods of direct patient contact. "Other HCWs" had the most direct daily contact with all other HCWs. Physicians also reported significantly more locations visited per week than nurses, other HCW, or administrators; nurses visited the fewest. Public spaces such as the cafeteria had the most staff visits per week, but the least mean hours spent per visit. Inpatient settings had significantly more HCW interactions per week than outpatient settings. HCW contact patterns and spatial movement demonstrate significant heterogeneity by occupation. Control strategies that address this diversity among health care workers may be more effective than "one-strategy-fits-all" HAI prevention and control programs.

Effects of revised consultation room design on patient-physician communication.

PubMed

Ajiboye, Folaranmi; Dong, Fanglong; Moore, Justin; Kallail, K James; Baughman, Allison

2015-01-01

To evaluate the impact of a revised consultation room design on patient-physician interaction in an outpatient setting. The growth of ambulatory medical care makes outpatient facilities the primary point of health care contact for many Americans. However, the outpatient consultation room design remains largely unchanged, despite its increased use and the adoption of technology-mediated information sharing in clinical encounter. A randomized controlled trial used a postvisit questionnaire to assess six domains of interest (satisfaction with the visit and the consultation room, mutual respect, patient trust in the physician, communication quality, people-room interaction, and interpersonal-room interaction) in two different room designs (a traditional room and an experimental room in which a pedestal table had replaced the examination table). Interpersonal-room interaction was enhanced in the experimental consultation room when compared to the traditional consultation room (p = .0038). Participants in the experimental consultation room had better access to the computer screen, increased provider information sharing, and more time engaging providers in conversation about information on the monitor. Changing the layout of a consultation room has the potential to improve interpersonal communication through better information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter should consider changing the layout of their consultation room, especially the positioning of the computer screen. © The Author(s) 2014.

Childhood abuse and current interpersonal conflict: the role of shame.

PubMed

Kim, Jungmeen; Talbot, Nancy L; Cicchetti, Dante

2009-06-01

To examine whether shame-proneness mediates the relationship between women's histories of childhood sexual abuse and their current partner and family conflict and child maltreatment. Previous research has found that women with childhood sexual abuse histories experience heightened shame and interpersonal conflict. However, research examining the relationship of shame to interpersonal conflict is lacking. Participants were 129 mothers of children enrolled in a summer camp program for at-risk children from financially disadvantaged families. Data were collected on women's childhood abuse histories, shame in daily life, and current interpersonal conflict involving family conflict, intimate partner conflict (verbal and physical aggression), and child maltreatment. Consistent with our hypothesis, the results of hierarchical regressions and logistic regression indicated that shame significantly mediated the association between childhood sexual abuse and interpersonal conflict. Women with sexual abuse histories reported more shame in their daily lives, which in turn was associated with higher levels of conflicts with intimate partners (self-verbal aggression and partner-physical aggression) and in the family. Shame did not mediate the relationship between mothers' histories of sexual abuse and child maltreatment. The role of shame in the intimate partner and family conflicts of women with sexual abuse histories has not been examined. The current findings indicate that childhood sexual abuse was related to interpersonal conflicts indirectly through the emotion of shame. These findings highlight the importance of investigating the role of shame in the interpersonal conflicts of women with histories of childhood sexual abuse. Healthcare professionals in medical and mental health settings frequently treat women with abuse histories who are involved in family and partner conflicts. Assessing and addressing the links of abused women's shame to interpersonal conflicts could be important in clinical interventions.

Australian eldercare providers: comparing volunteers and temporary staff on work environment, interpersonal relationships, and self-efficacy.

PubMed

Ferrari, Joseph R

2004-12-01

Volunteers (n = 52) and temporary employees (n = 49) at a nonprofit, health care program for the elderly in Australia completed measures on community self-efficacy, sense of community, and caregiver satisfaction and stress. Results indicated that both samples of respondents experienced a relatively strong sense of common mission to help the elderly, but volunteers, compared to employees, reported stronger self-efficacy about making a difference in their community. Volunteers, in comparison to temporary (or casual, the preferred term in Australia) employees, also reported a stronger sense of reciprocal responsibility to help their peers but stronger disharmony among members. Employees compared to volunteers reported greater satisfaction as a caregiver. Implications suggest marked differences in experiences of eldercare among volunteer and temporary employees working with the elderly.

Caring across boundaries versus keeping boundaries intact: links between moral values and interpersonal orientations.

PubMed

Niemi, Laura; Young, Liane

2013-01-01

Prior work has established robust diversity in the extent to which different moral values are endorsed. Some people focus on values related to caring and fairness, whereas others assign additional moral weight to ingroup loyalty, respect for authority and established hierarchies, and purity concerns. Five studies explore associations between endorsement of distinct moral values and a suite of interpersonal orientations: Machiavellianism, prosocial resource distribution, Social Dominance Orientation, and reported likelihood of helping and not helping kin and close friends versus acquaintances and neighbors. We found that Machiavellianism (Studies 1, 3, 4, 5) (e.g., amorality, controlling and status-seeking behaviors) and Social Dominance Orientation (Study 4) were negatively associated with caring values, and positively associated with valuation of authority. Those higher in caring values were more likely to choose prosocial resource distributions (Studies 2, 3, 4) and to report reduced likelihood of failing to help kin/close friends or acquaintances (Study 4). Finally, greater likelihood of helping acquaintances was positively associated with all moral values tested except authority values (Study 4). The current work offers a novel approach to characterizing moral values and reveals a striking divergence between two kinds of moral values in particular: caring values and authority values. Caring values were positively linked with prosociality and negatively associated with Machiavellianism, whereas authority values were positively associated with Machiavellianism and Social Dominance Orientation.

Impact of emotional competence on supportive care needs, anxiety and depression symptoms of cancer patients: a multiple mediation model.

PubMed

Baudry, A-S; Lelorain, S; Mahieuxe, M; Christophe, V

2018-01-01

The aim of this study was to test the effect of intrapersonal and interpersonal emotional competence on cancer patients' supportive care needs, as mediated by anxiety and depression symptoms. Cross-sectional design: 137 cancer patients (42% breast or ovarian cancer, 58% gastrointestinal cancer) in 4 French hospitals completed the Profile of Emotional Competence (PEC), the Hospital Anxiety and Depression Scale (HADS), and the Supportive Care Needs Survey Short Form (SCNS-SF). Bootstrap methods with PROCESS Macro were used to test multiple mediation models. Emotional competence presented a direct or indirect beneficial effect on the satisfaction of supportive care needs, anxiety and depression symptoms. As expected, anxiety and depression symptoms had also strong positive correlations with unmet needs. All multiple mediation models were significant, except for physical needs: intrapersonal and interpersonal emotional competence impacted anxiety and depression symptoms, which in turn impacted psychological, sexual, care/support, and information needs. These innovative results show the important effect of patients' emotional competence on their supportive care need satisfaction, as mediated by anxiety and depression. Consequently, patients with high emotional competence may require less psychosocial input from medical clinicians. Thus, emotional competence may be integrated into health models and psychosocial interventions to improve patient adjustment. Further investigation is, however, needed to know which are the most beneficial specific emotional competences and at what point of the cancer pathway.

Caring across Boundaries versus Keeping Boundaries Intact: Links between Moral Values and Interpersonal Orientations

PubMed Central

Niemi, Laura; Young, Liane

2013-01-01

Prior work has established robust diversity in the extent to which different moral values are endorsed. Some people focus on values related to caring and fairness, whereas others assign additional moral weight to ingroup loyalty, respect for authority and established hierarchies, and purity concerns. Five studies explore associations between endorsement of distinct moral values and a suite of interpersonal orientations: Machiavellianism, prosocial resource distribution, Social Dominance Orientation, and reported likelihood of helping and not helping kin and close friends versus acquaintances and neighbors. We found that Machiavellianism (Studies 1, 3, 4, 5) (e.g., amorality, controlling and status-seeking behaviors) and Social Dominance Orientation (Study 4) were negatively associated with caring values, and positively associated with valuation of authority. Those higher in caring values were more likely to choose prosocial resource distributions (Studies 2, 3, 4) and to report reduced likelihood of failing to help kin/close friends or acquaintances (Study 4). Finally, greater likelihood of helping acquaintances was positively associated with all moral values tested except authority values (Study 4). The current work offers a novel approach to characterizing moral values and reveals a striking divergence between two kinds of moral values in particular: caring values and authority values. Caring values were positively linked with prosociality and negatively associated with Machiavellianism, whereas authority values were positively associated with Machiavellianism and Social Dominance Orientation. PMID:24349095

Interpersonal issues between pain physician and patient: strategies to reduce conflict.

PubMed

Diesfeld, Kate

2008-11-01

This article analyzes scholarship on the interpersonal challenges that pain physicians face, with an emphasis on strategies to reduce conflicts within therapeutic relationships. Scholarship on the dilemmas pain physicians face suggests that 1) there are unique and perhaps unrecognized features of pain medicine that generate stress; 2) interpersonal conflict may contribute to stress; and 3) clinicians' biases may interfere with the doctor-patient relationship and with the best practice of pain medicine. Application of a framework based on clinicians' beliefs and Papadimos' reflections on justice and temperance may reduce such conflicts. The challenges of pain medicine may be complicated by the clinician's undisclosed attitudes regarding their roles and their perceptions of pain sufferers. A strategy for physicians to examine their beliefs within a supportive environment may aid physicians caring for people with chronic pain. Papadimos' reflections upon the virtues of justice and tolerance guide this analysis.

[The effect of assertiveness training on communication related factors and personnel turnover rate among hospital nurses].

PubMed

Kang, Myung Ja; Lee, Haejung

2006-08-01

The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

Healthy and maladaptive dependency and its relationship to pain management and perceptions in physical therapy patients.

PubMed

Huprich, Steven K; Hoban, Patrick; Boys, Ashley; Rosen, Alexandra

2013-12-01

This study examined the association among healthy and maladaptive aspects of interpersonal dependency and the management of pain in physical therapy outpatients. Ninety-eight patients were administered the Relationship Profile Test, West Haven-Yale Multidimensional Pain Inventory, and Pain Catastrophizing Scale. Results indicated that Destructive Overdependence was positively associated with an increased number of office visits, pain interference in one's daily life, pain severity, affective distress, and receiving positive partner responses. Dysfunctional Detachment was associated with affective distress, pain interference in one's daily life, and rumination about pain. Healthy Dependency was only associated with receiving distracting responses from others. Believing that a spouse/partner is supportive and caring about one's pain partially mediated the relationship between overdependency and pain interfering in one's life. These results support the clinical utility of assessing interpersonal dependency for its relationship to managing one's pain and health care utilization.

Stressors in clinical nursing education in Iran: A systematic review

PubMed Central

Changiz, Tahereh; Malekpour, Alireza; Zargham-Boroujeni, Ali

2012-01-01

Background: Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students’ learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports. Materials and Methods: In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also, the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of clinical education AND Nursing), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in Tables. Results: The following themes were obtained to classify main areas of importance for factors related to stress in clinical nursing education: a) clinical competence and ability to play one’s roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme. Conclusion: Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that interpersonal relationships and interactions is of the highest priority. PMID:23922579

The use of standardized patients in the plastic surgery residency curriculum: teaching core competencies with objective structured clinical examinations.

PubMed

Davis, Drew; Lee, Gordon

2011-07-01

As of 2006, the Accreditation Council for Graduate Medical Education had defined six "core competencies" of residency education: interpersonal communication skills, medical knowledge, patient care, professionalism, practice-based learning and improvement, and systems-based practice. Objective structured clinical examinations using standardized patients are becoming effective educational tools, and the authors developed a novel use of the examinations in plastic surgery residency education that assesses all six competencies. Six plastic surgery residents, two each from postgraduate years 4, 5, and 6, participated in the plastic surgery-specific objective structured clinical examination that focused on melanoma. The examination included a 30-minute videotaped encounter with a standardized patient actor and a postencounter written exercise. The residents were scored on their performance in all six core competencies by the standardized patients and faculty experts on a three-point scale (1 = novice, 2 = moderately skilled, and 3 = proficient). Resident performance was averaged for each postgraduate year, stratified according to core competency, and scored from a total of 100 percent. Residents overall scored well in interpersonal communications skills (84 percent), patient care (83 percent), professionalism (86 percent), and practice-based learning (84 percent). Scores in medical knowledge showed a positive correlation with level of training (86 percent). All residents scored comparatively lower in systems-based practice (65 percent). The residents reported unanimously that the objective structured clinical examination was realistic and educational. The objective structured clinical examination provided comprehensive and meaningful feedback and identified areas of strengths and weakness for the residents and for the teaching program. The examination is an effective assessment tool for the core competencies and a valuable adjunct to residency training.

Treating Conduct Problems and Strengthening Social and Emotional Competence in Young Children: The Dina Dinosaur Treatment Program.

ERIC Educational Resources Information Center

Webster-Stratton, Carolyn; Reid, M. Jamila

2003-01-01

This article describes the Dina Dinosaur Social, Emotional and Problem Solving Child Training Program for young children with conduct problems. The program emphasizes training children in skills such as emotional literacy, empathy or perspective taking, friendship and communication skills, anger management, interpersonal problem solving, and…

Customer Service Training for Public Services Staff at Temple University's Central Library System.

ERIC Educational Resources Information Center

Arthur, Gwen

Arguing that good interpersonal interactions between library staff and their patrons is a major determinant of overall patron satisfaction, this paper describes Temple University's customer service training program for its public services staff. Dubbed the "A+ Service" program, the program focuses on six aspects of library service: (1)…

Let's talk about empathy!

PubMed

Robieux, Léonore; Karsenti, Lucille; Pocard, Marc; Flahault, Cécile

2018-01-01

Research faces a challenge to find a shared, adequate and scientific definition of empathy. Our work aimed to analyze what clinical empathy is in the specific context of cancer care and to identify the effect of empathy in it. This study gives voice to physicians with extensive experience in cancer care. This original research combines qualitative data collection and quantitative data analysis. Semi-structured individual interviews were conducted with 25 physicians. The content of the interviews was analyzed according to the Content Analysis Technique. Empathy is described according to six dimensions that give a strong role to interpersonal and cognitive skills. This description integrates previous and various conceptualizations of clinical empathy. Physicians detail the beneficial effects of clinical empathy on patients' outcomes and well-being as well as physicians' practices. Physician interviews also revealed the relationship between empathic concerns and physicians' emotional difficulties. Empathy in cancer care is a complex process and a multicomponent competence. This operational description of clinical empathy has three main implications: to draw up a training program for physicians, to detail recommendations for physicians' work-related quality of life and to develop new tools to measure empathy. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictive value of cognition for different domains of outcome in recent-onset schizophrenia.

PubMed

Holthausen, Esther A E; Wiersma, Durk; Cahn, Wiepke; Kahn, René S; Dingemans, Peter M; Schene, Aart H; van den Bosch, Robert J

2007-01-15

The aim of this study was to see whether and how cognition predicts outcome in recent-onset schizophrenia in a large range of domains such as course of illness, self-care, interpersonal functioning, vocational functioning and need for care. At inclusion, 115 recent-onset patients were tested on a cognitive battery and 103 patients participated in the follow-up 2 years after inclusion. Differences in outcome between cognitively normal and cognitively impaired patients were also analysed. Cognitive measures at inclusion did not predict number of relapses, activities of daily living and interpersonal functioning. Time in psychosis or in full remission, as well as need for care, were partly predicted by specific cognitive measures. Although statistically significant, the predictive value of cognition with regard to clinical outcome was limited. There was a significant difference between patients with and without cognitive deficits in competitive employment status and vocational functioning. The predictive value of cognition for different social outcome domains varies. It seems that cognition most strongly predicts work performance, where having a cognitive deficit, regardless of the nature of the deficit, acts as a rate-limiting factor.

Intergroup communication between hospital doctors: implications for quality of patient care.

PubMed

Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A

2009-12-01

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

Community Agency Voice and Benefit in Service-Learning

ERIC Educational Resources Information Center

Miron, Devi; Moely, Barbara E.

2006-01-01

Supervisors from 40 community agencies working with a university-based service-learning program were interviewed regarding the extent of their input in service-learning program planning and implementation "(Agency Voice), Interpersonal Relations" with service-learning students, "Perceived Benefit" of the service-learning…

Challenges in building interpersonal care in organized hospital stroke units: The perspectives of stroke survivors, family caregivers and the multidisciplinary team.

PubMed

Ryan, Tony; Harrison, Madeleine; Gardiner, Clare; Jones, Amanda

2017-10-01

To explore the organized stroke unit experience from the multiple perspectives of stroke survivor, family carer and the multi-disciplinary team. Organized stroke unit care reduces morbidity, mortality and institutionalization and is promoted globally as the most effective form of acute and postacute provision. Little research has focused on how care is experienced in this setting from the perspectives of those who receive and provide care. This study used a qualitative approach, employing Framework Analysis. This methodology allows for a flexible approach to data collection and a comprehensive and systematic method of analysis. Semi-structured interviews were undertaken during 2011 and 2012 with former stroke unit stroke survivors, family carers and senior stroke physicians. In addition, eight focus groups were conducted with members of the multi-disciplinary team. One hundred and twenty-five participants were recruited. Three key themes were identified across all data sets. First, two important processes are described: responses to the impact of stroke and seeking information and stroke-specific knowledge. These are underpinned by a third theme: the challenge in building relationships in organized stroke unit care. Stroke unit care provides satisfaction for stroke survivors, particularly in relation to highly specialized medical and nursing care and therapy. It is proposed that moves towards organized stroke unit care, particularly with the emphasis on reduction of length of stay and a focus on hyper-acute models, have implications for interpersonal care practices and the sharing of stroke-specific knowledge. © 2017 John Wiley & Sons Ltd.

Depressive symptoms and interpersonal needs as mediators of forgiveness and suicidal behavior among rural primary care patients.

PubMed

Nsamenang, Sheri A; Webb, Jon R; Cukrowicz, Kelly C; Hirsch, Jameson K

2013-07-01

Suicide is the 10th leading cause of death in the US, and rates of suicide are higher in rural than urban areas. As proposed by the Interpersonal-Psychological Theory of Suicide, thwarted belongingness and perceived burdensomeness are risk factors for suicidal behavior, although protective individual-level characteristics such as forgiveness, may indirectly affect suicidal behavior by decreasing the deleterious effect of thwarted interpersonal needs. A sample of uninsured adults recruited from a rural primary clinic (N=101) completed the Brief Multidimensional Measure of Religiousness and Spirituality; Suicidal Behaviors Questionnaire-Revised; Interpersonal Needs Questionnaire; and Center for Epidemiologic Studies Depression Scale. Parallel and serial multivariable mediation analyses were conducted to test for direct and indirect effects of forgiveness on suicidal behavior. In parallel mediation, covarying depressive symptoms, forgiveness of self had an indirect effect on suicidal behavior, through perceived burdensomeness. Inclusion of depressive symptoms as a mediator revealed an indirect effect of forgiveness of self and others on suicidal behavior via depression, thwarted belongingness, and perceived burdensomeness in a serial mediation model. A longitudinal study, with an equal representation of males and diverse populations is needed to replicate our findings. Our findings have implications for the role health providers can play in addressing suicide with rural patients. Promoting forgiveness, may, in turn affect interpersonal functioning and decrease risk for suicidal behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

Development and evaluation of a learner-centered educational summer camp program on soft skills for baccalaureate nursing students.

PubMed

Lau, Ying; Wang, Wenru

2014-01-01

The objectives were to develop a learner-centered educational camp program for nursing students and to evaluate 4 areas of soft skills, communication ability, clinical interaction, interpersonal relationships, and social problem solving, before and after the program. The results showed that the summer camp program was effective in improving nursing students' soft skills.

Social workers' perceptions of barriers to interpersonal therapy implementation for treating postpartum depression in a primary care setting in Israel.

PubMed

Bina, Rena; Barak, Adi; Posmontier, Barbara; Glasser, Saralee; Cinamon, Tali

2018-01-01

Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols. © 2017 John Wiley & Sons Ltd.

Esperanza y Vida: A Culturally and Linguistically Customized Breast and Cervical Education Program for Diverse Latinas at Three Different United States Sites

PubMed Central

Jandorf, Lina; Ellison, Jennie; Shelton, Rachel; Thélémaque, Linda; Castillo, Anabella; Mendez, Elsa Iris; Horowitz, Carol; Treviño, Michelle; Doty, Bonnie; Hannigan, Maria; Aguirre, Elvira; Harfouche-Saad, Frances; Colon, Jomary; Matos, Jody; Pully, Leavonne; Bursac, Zoran; Erwin, Deborah O.

2015-01-01

Breast cancer is the most common cause of cancer and the leading cause of cancer death among Latinas in the United States. In addition, Latinas experience a disproportionate burden of cervical cancer incidence, morbidity, and mortality compared with non-Hispanic White women. Lower use of breast and cervical cancer screening services may contribute to these disparities. To address the underutilization of breast and cervical cancer screening among diverse subgroups of Latinas, a peer-led education program called Esperanza y Vida (“Hope and Life”) was developed and administered at 3 sites (2 in New York and 1 in Arkansas). Immigrant Latina women and their partners were educated about the importance of breast and cervical cancer screening, with the goals of increasing their knowledge about these cancers and their screening behavior. An analysis of the intervention’s findings at baseline among female participants demonstrated significant sociodemographic, interpersonal, cultural, health care system, and program variability in 3 distinct geographic regions in the United States. These data indicate the need for and feasibility of customizing cancer outreach and educational programs for diverse Latina subgroups living in various U.S. regions, with implications for informing the expansion and replication of the program in other regions of the country. PMID:22059729

Staff and relatives' perspectives on the aggressive behaviour of older people with dementia in residential care: a qualitative study.

PubMed

Duxbury, J; Pulsford, D; Hadi, M; Sykes, S

2013-11-01

Staff and relative perspectives on patient aggression in dementia care units are seriously under researched in the U.K. Any work that has been conducted has relied upon quantitative studies. Qualitative research on aggression management in older peoples services are rare. In-depth views that can offer insights into causation and management strategies are therefore under represented in the literature. In order to investigate this issue further we interviewed a number of nursing staff and relatives in four U.K. care homes in the North West of England. Using a combined approach of one-to-one interviews (for staff) and focus groups (for relatives) we explored their views as to the reasons for and ways of responding to aggressive behaviour. This was part of a larger study reported upon elsewhere. Using thematic analysis we found similar results from both staff and relatives and as such their views were categorized into two broad areas: causation and management. In regards to causation we noted three sub-themes; internal, external and interpersonal factors which are further subdivided in the paper and for management two broad categories: the compassionate approach and 'don't go in strong'. The results indicated that staff in the participating units embraced a person-centred approach to aggression management. They predominantly respond to aggressive incidents with interpersonal strategies, such as distraction as opposed to medication or restraint. Overall they adopt a person centre approach to patient care. Relatives were clear in their perceptions of aggression as an interpersonal challenge, which is compounded or mediated by the illness of dementia. Consequently they were positive in their views of staff using non-coercive interventions. While the results of this and our earlier study are promising suggesting a less invasive approach to this aspect of dementia care, given the limitations of a small sample, more research of a similar nature is warranted. Findings from multidimensional studies can then provide a sounder basis for health and social care education, and person centred informed practice to reduce the incidence of aggression through preventative strategies. © 2012 John Wiley & Sons Ltd.

Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

PubMed

van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

2016-05-28

The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.

The institutional logic of integrated care: an ethnography of patient transitions.

PubMed

Shaw, James A; Kontos, Pia; Martin, Wendy; Victor, Christina

2017-03-20

Purpose The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences inter-relate in the implementation of integrated transitional care out of hospital in the English National Health Service. Design/methodology/approach The authors conducted an ethnographic case study of a hospital and surrounding services within a large urban centre in England. Specific methods included qualitative interviews with patients/caregivers, health/social care providers, and organizational leaders; observations of hospital transition planning meetings, community "hub" meetings, and other instances of transition planning; reviews of patient records; and analysis of key policy documents. Analysis was iterative and informed by theory on institutional logics and institutional entrepreneurship. Findings Organizational leaders at the meso-level of health and social care promoted a partnership logic of integrated care in response to conflicting institutional ideas found within a key macro-level policy enacted in 2003 (The Community Care (Delayed Discharges) Act). Through institutional entrepreneurship at the micro-level, the partnership logic became manifest in the form of relationship work among health and social care providers; they sought to build strong interpersonal relationships to enact more integrated transitional care. Originality/value This study has three key implications. First, efforts to promote integrated care should strategically include institutional entrepreneurs at the organizational and clinical levels. Second, integrated care initiatives should emphasize relationship-building among health and social care providers. Finally, theoretical development on institutional logics should further examine the role of interpersonal relationships in facilitating the "spread" of logics between macro-, meso-, and micro-level influences on inter-organizational change.

Impact of National Institutes of Health Gastrointestinal PROMIS Measures in Clinical Practice: Results of a Multicenter Controlled Trial.

PubMed

Almario, Christopher V; Chey, William D; Khanna, Dinesh; Mosadeghi, Sasan; Ahmed, Shahzad; Afghani, Elham; Whitman, Cynthia; Fuller, Garth; Reid, Mark; Bolus, Roger; Dennis, Buddy; Encarnacion, Rey; Martinez, Bibiana; Soares, Jennifer; Modi, Rushaba; Agarwal, Nikhil; Lee, Aaron; Kubomoto, Scott; Sharma, Gobind; Bolus, Sally; Spiegel, Brennan M R

2016-11-01

The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS) to allow efficient, online measurement of patient-reported outcomes (PROs), but it remains untested whether PROMIS improves outcomes. Here, we aimed to compare the impact of gastrointestinal (GI) PROMIS measures vs. usual care on patient outcomes. We performed a pragmatic clinical trial with an off-on study design alternating weekly between intervention (GI PROMIS) and control arms at one Veterans Affairs and three university-affiliated specialty clinics. Adults with GI symptoms were eligible. Intervention patients completed GI PROMIS symptom questionnaires on an e-portal 1 week before their visit; PROs were available for review by patients and their providers before and during the clinic visit. Usual care patients were managed according to customary practices. Our primary outcome was patient satisfaction as determined by the Consumer Assessment of Healthcare Providers and Systems questionnaire. Secondary outcomes included provider interpersonal skills (Doctors' Interpersonal Skills Questionnaire (DISQ)) and shared decision-making (9-item Shared Decision Making Questionnaire (SDM-Q-9)). There were 217 and 154 patients in the GI PROMIS and control arms, respectively. Patient satisfaction was similar between groups (P>0.05). Intervention patients had similar assessments of their providers' interpersonal skills (DISQ 89.4±11.7 vs. 89.8±16.0, P=0.79) and shared decision-making (SDM-Q-9 79.3±12.4 vs. 79.0±22.0, P=0.85) vs. This is the first controlled trial examining the impact of NIH PROMIS in clinical practice. One-time use of GI PROMIS did not improve patient satisfaction or assessment of provider interpersonal skills and shared decision-making. Future studies examining how to optimize PROs in clinical practice are encouraged before widespread adoption.

Women's perception of quality of maternity services: a longitudinal survey in Nepal.

PubMed

Karkee, Rajendra; Lee, Andy H; Pokharel, Paras K

2014-01-24

In the context of maternity service, the mother's assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression. Within the health facility sub-scale, birth centre was rated lowest on items 'adequacy of medical equipment', 'health staff suited to women's health' and 'adequacy of health staff', whereas public hospital was rated the lowest with respect to 'adequacy of room', 'adequacy of water', 'environment clean', 'privacy' and 'adequacy of information'. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (p < 0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (p < 0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p < 0.001). Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality.

Integrating Behavioral Health and Primary Care: Consulting, Coordinating and Collaborating Among Professionals.

PubMed

Cohen, Deborah J; Davis, Melinda; Balasubramanian, Bijal A; Gunn, Rose; Hall, Jennifer; deGruy, Frank V; Peek, C J; Green, Larry A; Stange, Kurt C; Pallares, Carla; Levy, Sheldon; Pollack, David; Miller, Benjamin F

2015-01-01

This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. Primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems. Organizations can create integrated care environments that support these collaborations and health professions training programs should equip clinicians to execute all 3Cs routinely in practice. © Copyright 2015 by the American Board of Family Medicine.

The 80-hour work week for residents: views from obstetric and gynecology program directors.

PubMed

Janoo, Jabin; Hashmi, Mahreen; Seybold, Dara J; Shapiro, Robert; Calhoun, Byron C; Bush, Stephen H

2014-01-01

In 2003, the Accreditation Council for Graduate Medical Education mandated an 80-hour work week restriction for residency programs. We examined program directors' views on how this mandate affects the education of Obstetrics and Gynecology residents. A 25 question survey was administered via Survey Monkey to Obstetrics and Gynecology program directors in the United States over three months in 2011. Fifty program directors (response rate of 28%) completed it with more men (62%) than women (38%) respondents. Overall, only 28% (14/50) responded that the program had improved, with significantly fewer men (5/14; 16.1%) than women (47.4% 9/19; p < 0.0169) directors reporting this. There was little perceived improvement in any of the six core ACGME performance objectives and in the CREOG scores, with the improvement ranging from 8% to 12%. In fact, while we observed the percentage of women directors reporting improvement in patient care and interpersonal and communication skills significantly higher compared with their male counterparts, the majority of women still reported either no improvement or a decline in these areas. Though our sample size was small, we found some significant difference between the views of male and female program directors. Both groups nonetheless responded with the majority with a decline or no change rather than a perceived improvement in any of the educational endeavors studied.

The 80-hour Work Week for Residents: Views from Obstetric and Gynecology Program Directors

PubMed Central

Janoo, Jabin; Hashmi, Mahreen; Seybold, Dara J.; Shapiro, Robert; Calhoun, Byron C.; Bush, Stephen H.

2015-01-01

In 2003, the Accreditation Council for Graduate Medical Education mandated an 80-hour work week restriction for residency programs. We examined program directors’ views on how this mandate affects the education of Obstetrics and Gynecology residents. A 25 question survey was administered via Survey Monkey to Obstetrics and Gynecology program directors in the United States over three months in 2011. Fifty program directors (response rate of 28%) completed it with more men (62%) than women (38%) respondents. Overall, only 28% (14/50) responded that the program had improved, with significantly fewer men (5/14; 16.1%) than women (47.4% 9/19; p<0.0169) directors reporting this. There was little perceived improvement in any of the six core ACGME performance objectives and in the CREOG scores, with the improvement ranging from 8% to 12%. In fact, while we observed the percentage of women directors reporting improvement in patient care and interpersonal and communication skills significantly higher compared with their male counterparts, the majority of women still reported either no improvement or a decline in these areas. Though our sample size was small, we found some significant difference between the views of male and female program directors. Both groups nonetheless responded with the majority with a decline or no change rather than a perceived improvement in any of the educational endeavors studied. PMID:25643470

Pastoral Care and Counseling with Military Families.

PubMed

Moon, Zachary

2016-06-01

The complex human experience of military service and the stress suffered by millions of military families each time a loved one deploys present unique challenges and opportunities in providing pastoral care and counseling. War and military service impact many facets of our society, as well as generational and interpersonal relationships. This article speaks to both academic and practitioner communities, and provides a vision for effective pastoral care and counseling with military families drawing on resources from family systems theory. © The Author(s) 2016.

Professorship: A Faculty Development Program.

ERIC Educational Resources Information Center

Davis, Todd M.; Davis, Jane F.

1987-01-01

A faculty development program at a traditionally black college was designed to enhance the ability of graduate faculty to supervise research activities of graduate students. Focus was on interpersonal problem solving in advisement and professional issues; classroom techniques of discussion teaching, case methods, and psychodrama encouraged the…

Mapping interpersonal communication between pediatricians and mothers: understandings, interdependencies and gaps.

PubMed

Mookerjee, Devalina

2013-12-01

Interpersonal communication between pediatricians and mothers is both complex and interdependent. The mother is dependent on the pediatrician for her child's wellbeing and care along expertise-related dimensions for which she cannot provide. The pediatrician is dependent on the mother's ability to provide accurate information about the child's health and habits, so that the doctor, who has limited time with the child, is able to make continuing accurate diagnoses. This paper seeks to provide a basic understanding of interpersonal mis-/communication between mothers and pediatricians, a complex area which has not heretofore been mapped in the contemporary Indian context. Therefore, the paper presents a small-scale exploratory qualitative study based on in-depth interviews with both doctors and mothers in the city of Kolkata (Calcutta), India. It focuses on providing an understanding of the factors that may enable or disenable instrumental or relational communication in the mother-pediatrician situation. Four major themes emerge from the data: first, the shifting borders of information between pediatricians and parents; second, the respective roles of verbal and non-verbal communication in the consultation; third, a tension between the traditional and the modern; and fourth, understandings of professional and interpersonal relationship in the context of responsibility for a child.

Avoid falling for a jerk(ette): Effectiveness of the Premarital Interpersonal Choices and Knowledge Program among Emerging Adults.

PubMed

Bradford, Kay; Stewart, J Wade; Pfister, Roxane; Higginbotham, Brian J

2016-10-01

Premarital education may help emerging adults form healthy relationships, but evaluation research is needed, particularly with community samples. We studied emerging adults in the Premarital Interpersonal Choices and Knowledge (PICK) program, using a pre- to post- and a posttest-then-retrospective-pretest design to examine change in perceived relationship skills, partner selection, relational patterns, and relationship behaviors and attitudes. Mixed models analyses showed that scores for the treatment group (n = 682) increased from pre to post on all four outcomes. Changes in scores for the nonequivalent comparison group (n = 462) were nonsignificant. In addition, significant differences between pre- and retrospective prescores demonstrated evidence for response shift bias. The results suggest that the PICK program helps participants increase their knowledge regarding the components of healthy relationship formation. © 2016 American Association for Marriage and Family Therapy.

Recruitment strategies and costs for a community-based physical activity program.

PubMed

Peck, Lara E; Sharpe, Patricia A; Burroughs, Ericka L; Granner, Michelle L

2008-04-01

A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

The Positive Action Program: Improving Academics, Behavior, and Character by Teaching Comprehensive Skills for Successful Learning and Living

ERIC Educational Resources Information Center

Flay, Brian R.; Allred, Carol G.

2010-01-01

This chapter outlines and provides evidence for the effects of the "Positive Action Program" as a way of inculcating values, driving student wellbeing, and improving academic performance and interpersonal behavior. The program centers on addressing behavioral, emotional, and academic problems by developing in individuals positive beliefs…

Correctional Officers and Workplace Adversity: Identifying Interpersonal, Cognitive, and Behavioral Response Tendencies.

PubMed

Trounson, Justin S; Pfeifer, Jeffrey E

2017-10-01

This study explored correctional officers' response tendencies (i.e., cognitive, interpersonal, and behavioral response patterns they engage in) when managing workplace adversity. In total, 53 Australian correctional officers participated in the study. Eight exploratory focus group discussions ( n = 42) were conducted to identify a set of officer-endorsed response tendencies. Thematic analysis of group data revealed that correctional officers engage in a range of response tendencies when facing workplace adversity and that these tendencies may be categorized as interpersonally, cognitively, or behaviorally based. Semistructured interviews ( n = 11) were then conducted to provide further depth of information regarding officer response tendency usage. Results are discussed in terms of common themes, future research, and implications for developing training programs designed to ameliorate the effects of workplace adversity.

An integrated model for adolescent inpatient group therapy.

PubMed

Garrick, D; Ewashen, C

2001-04-01

This paper proposes an integrated group therapy model to be utilized by psychiatric and mental health nurses; one innovatively designed to meet the therapeutic needs of adolescents admitted to inpatient psychiatric programs. The writers suggest a model of group therapy primarily comprised of interpersonal approaches within a feminist perspective. The proposed group focus is on active therapeutic engagement with adolescents to further interpersonal learning and to critically examine their contextualized lived experiences. Specific client and setting factors relevant to the selection of therapeutic techniques are reviewed. Selected theoretical models of group therapy are critiqued in relation to group therapy with adolescents. This integrated model of group therapy provides a safe and therapeutic forum that enriches clients' personal and interpersonal experiences as well as promotes healthy exploration, change, and empowerment.

The Efficacy of Conflict-Mediation Training in Elementary Schools.

ERIC Educational Resources Information Center

Campbell, Karen

2003-01-01

Conflict resolution training teaches students to manage interpersonal conflict more constructively. This approach to safe schools has benefits but needs more research to demonstrate effectiveness. Alberta's Safe and Caring Schools project is a replicable example. (Contains 25 references.) (SK)

Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.

PubMed

Jennings, B M; Loan, L A

1999-11-01

A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.

Identifying management competencies for health care executives: review of a series of Delphi studies.

PubMed

Hudak, R P; Brooke, P P; Finstuen, K

2000-01-01

This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.

Project Kealahou: Improving Hawai‘i's System of Care for At-Risk Girls and Young Women through Gender-Responsive, Trauma-Informed Care

PubMed Central

Jackson, David S; Slavin, Lesley A; Michels, M Stanton; McGeehan, Kathleen M

2014-01-01

Project Kealahou (PK) is a six-year, federally-funded program aimed at improving services and outcomes for Hawai‘i's female youth who are at risk for running away, truancy, abuse, suicide, arrest and incarceration. PK builds upon two decades of sustained cross-agency efforts among the state's mental health, juvenile justice, education, and child welfare systems to promote system-of-care (SOC) principles of community-based, individualized, culturally and linguistically competent, family driven, youth-guided, and evidence-based services. In addition, PK emphasizes trauma-informed and gender-responsive care in serving its target population of females ages 11–18 years who have experienced psychological trauma. Results from the first four years of the implementation of PK in the Department of Health's (DOH) Child and Adolescent Mental Health Division (CAMHD) highlight the serious familial, socioeconomic, functional, and interpersonal challenges faced by the young women who receive services in Hawai‘i's SOC. Despite the challenges faced by PK youth and their families, preliminary results of the evaluation of PK show significant improvements across multiple clinical and functional domains of service recipients. A financial analysis indicates that these outcomes were obtained with a minimal overall increase in costs when compared to standard care alone. Overall, these results suggest that PK may offer a cost effective way to improve access, care, and outcomes for at-risk youth and their families in Hawai‘i. PMID:25628971

Barriers and facilitators to smoking cessation in pregnancy and in the post-partum period: The health care professionals' perspective.

PubMed

Naughton, Felix; Hopewell, Sarah; Sinclair, Lesley; McCaughan, Dorothy; McKell, Jennifer; Bauld, Linda

2018-05-15

Health care professionals and the health care environment play a central role in protecting pregnant and post-partum women and their infants from smoking-related harms. This study aimed to better understand the health professional's perspective on how interactions between women, health care professionals, and the environment influence how smoking is managed. Semi-structured interviews and focus groups. Data were from 48 health care staff involved in antenatal or post-partum care at two UK sites, including midwives, obstetricians, health visitors, GPs, pharmacists, service commissioners, and Stop Smoking Service (SSS) advisors and managers. Thematic analysis was guided by a social-ecological framework (SEF). Themes were divided across three SEF levels and represented factors connected to the management of smoking in the health care context and the beliefs and behaviour of pregnant or post-partum smokers. Organizational level: Service reconfigurations, 'last resort' nicotine replacement therapy prescribing policies, and non-mandatory training were largely negative factors. There were mixed views on opt-out referral pathways and positive views on carbon monoxide monitoring. Interpersonal level: Protection of client-professional relationships often inhibited frank discussions about smoking, and weak interservice relationships affected SSS referral motivation and quality. Individual level: Professionals felt community midwives had primary responsibility for managing smoking, although midwives felt underskilled doing this. Midwives' perceived priority for addressing smoking was influenced by the demands from unrelated organizational initiatives. Opportunities to improve clinical support for pregnant smokers exist at organizational, interservice, and health care professional levels. Interactions between levels reflect the importance of simultaneously addressing different level-specific barriers to smoking cessation in pregnancy. Statement of contribution What is already known on this subject? Few health care professionals discuss smoking cessation support with pregnant or post-partum women. Identified health care professional-related barriers to supporting pregnant and post-partum women to stop smoking include deficits in knowledge and confidence, perceived lack of time, and concerns about damaging client relationships. There is currently a gap in understanding regarding the barriers and facilitators to supporting this group and how interactions between the health care environment and health care professionals influence the way smoking is addressed. What does this study add? This study identifies modifiable factors that can influence cessation support delivery to pregnant and post-partum women. These factors are mapped across organizational, interpersonal, and individual health care professional levels. Service structure, communication pathways, and policies appear to influence what cessation support is offered. Interpersonal and individual factors influence how this support is delivered. © 2018 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Enhancing Family Literacy through Collaboration: Program Considerations.

ERIC Educational Resources Information Center

Tice, Carolyn J.

2000-01-01

Presents findings from a two-year evaluation of a family literacy program in rural Appalachian Ohio. Demonstrates positive results for both impact/outcome and process objectives. Highlights an extensive network of interpersonal and interagency relationships that maximized resources and supported families as they changed. Suggests the importance of…

Dropout Prevention: An Intervention Model for Today's High Schools.

ERIC Educational Resources Information Center

Maurer, Richard D.

1982-01-01

Describes Project Intercept in Ossining (New York), which cut the high school's dropout, absence, and failure rates by involving teachers, students, and families. The program uses four major strategies--teacher/staff inservice training, alternative academic programs, student training in social and interpersonal skills, and family intervention…

Perspectives on Home Care Quality

PubMed Central

Kane, Rosalie A.; Kane, Robert L.; Illston, Laurel H.; Eustis, Nancy N.

1994-01-01

Home care quality assurance (QA) must consider features inherent in home care, including: multiple goals, limited provider control, and unique family roles. Successive panels of stakeholders were asked to rate the importance of selected home care outcomes. Most highly rated outcomes were freedom from exploitation, satisfaction with care, physical safety, affordability, and physical functioning. Panelists preferred outcome indicators to process and structure, and all groups emphasized “enabling” criteria. Themes highlighted included: interpersonal components of care; normalizing life for clientele; balancing quality of life with safety; developing flexible, negotiated care plans; mechanisms for accountability and case management. These themes were formulated differently according to the stakeholders' role. Providers preferred intermediate outcomes, akin to process. PMID:10140158

Sustained reduction in health care costs after adjunctive treatment of graded intensive short-term dynamic psychotherapy in patients with psychotic disorders.

PubMed

Abbass, Allan; Bernier, Denise; Kisely, Steve; Town, Joel; Johansson, Robert

2015-08-30

The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 13 one-hour sessions of graded ISTDP to 38 patients with psychotic disorders. Costs for health care services were compiled for a one-year period prior to the start of ISTDP (baseline) along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Results revealed that health care cost reductions were significant for the one-year post-treatment period relative to baseline year, for both physician costs and hospital costs, and the reductions were sustained for the follow-up period of four post-treatment years. Furthermore, at treatment termination self-reported symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and reduce costs in selected patients with psychotic disorders, and that gains are sustained in long-term follow-up. Future research directions are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Smoking prevention in children and adolescents: A systematic review of individualized interventions.

PubMed

Duncan, Lindsay R; Pearson, Erin S; Maddison, Ralph

2018-03-01

This study systematically reviewed the literature to determine what type of cognitive-behavioral based interventions administered outside of formal school settings effectively prevent smoking initiation among children and adolescents. Applying the PRISMA guidelines we searched MEDLINE, PsycINFO, CINHAL, Pub Med, SCOPUS, and Sport Discus. Article review, data extraction, and assessment of risk of bias were conducted by two independent reviewers. We included 16 studies administered in various settings: seven in health care; four informally during and outside of school hours; three in the home; and two in extra-curricular settings. Positive preventive effects in smoking behavior ranging from 3-months to 4-years were observed in eight studies. Social environmental influences (e.g., parental smoking, friends) are salient contributing factors. Effective approaches involved interventions conducted in health care settings as well as those employing interpersonal communication and support strategies (e.g., via peer leaders, parent support, physicians). Primary health care settings may be optimal for implementing cigarette smoking prevention interventions for children and adolescents. Providing tailored education and facilitating interpersonal discussions between health care providers and families about the risks of smoking/strategies to avoid uptake, as well as capitalizing on technology-based modalities may reduce rates among children and adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

A Content Validity Study of AIMIT (Assessing Interpersonal Motivation in Transcripts).

PubMed

Fassone, Giovanni; Lo Reto, Floriana; Foggetti, Paola; Santomassimo, Chiara; D'Onofrio, Maria Rita; Ivaldi, Antonella; Liotti, Giovanni; Trincia, Valeria; Picardi, Angelo

2016-07-01

Multi-motivational theories of human relatedness state that different motivational systems with an evolutionary basis modulate interpersonal relationships. The reliable assessment of their dynamics may usefully inform the understanding of the therapeutic relationship. The coding system of the Assessing Interpersonal Motivation in Transcripts (AIMIT) allows to identify in the clinical the activity of five main interpersonal motivational systems (IMSs): attachment (care-seeking), caregiving, ranking, sexuality and peer cooperation. To assess whether the criteria currently used to score the AIMIT are consistently correlated with the conceptual formulation of the interpersonal multi-motivational theory, two different studies were designed. Study 1: Content validity as assessed by highly qualified independent raters. Study 2: Content validity as assessed by unqualified raters. Results of study 1 show that out of the total 60 AIMIT verbal criteria, 52 (86.7%) met the required minimum degree of correspondence. The average semantic correspondence scores between these items and the related IMSs were quite good (overall mean: 3.74, standard deviation: 0.61). In study 2, a group of 20 naïve raters had to identify each prevalent motivation (IMS) in a random sequence of 1000 utterances drawn from therapy sessions. Cohen's Kappa coefficient was calculated for each rater with reference to each IMS and then calculated the average Kappa for all raters for each IMS. All average Kappa values were satisfactory (>0.60) and ranged between 0.63 (ranking system) and 0.83 (sexuality system). Data confirmed the overall soundness of AIMIT's theoretical-applicative approach. Results are discussed, corroborating the hypothesis that the AIMIT possesses the required criteria for content validity. Copyright © 2015 John Wiley & Sons, Ltd. Assessing Interpersonal Motivations in psychotherapy transcripts as a useful tool to better understand links between motivational systems and intersubjectivity. A step forward in the knowledge of evolutionary cognitivism and a contribution to the bio-psycho-social model of human relatedness and interpersonal neurobiology. Copyright © 2015 John Wiley & Sons, Ltd.

Are personal characteristics of massage therapists associated with their clinical, educational, and interpersonal behaviors?

PubMed Central

Boulanger, Karen; Campo, Shelly

2013-01-01

Background Social Cognitive Theory suggests that characteristics of health professionals, such as their beliefs in the effectiveness of their care, influence their behavior. Studying the characteristics of massage therapists may, therefore, provide insight into their clinical, educational and interpersonal behavior, which ultimately affects their client interactions. Purpose To examine the association of three personal factors (outcome expectations, expectancies, and practice experience) of the massage therapist and the practice environment with the frequency of three interventional behaviors (clinical, educational, and interpersonal) using Social Cognitive Theory as a theoretical framework. Methods A random sample of licensed massage therapists in Iowa completed a mailed questionnaire. Questions included training in massage, use of specific massage techniques and practices, 11 outcome expectations, and 17 different behaviors with their respective expectancies for contributing to favorable client outcomes. Factor analyses were conducted on the behavior and expectancy items. Regression analyses were used to examine the relationship of massage therapist characteristics to the different categories of behavior. Results The response rate was 40% (N = 151). The most common techniques employed were Swedish massage, trigger point therapy, and stretching. The most common practices recommended to clients were encouraging water intake, heat application, stretching, stress management, and exercise counseling. Expectancies was the only Social Cognitive Theory variable that significantly predicted the frequency of every category of behavior (clinical, interpersonal, education; all ps < .01). Outcome expectations predicted clinical (p = .03) and educational (p < .01), but not interpersonal behavior. No other associations reached statistical significance. Conclusions Massage therapists’ belief in massage to enact a favorable change in a client is strongly associated with their clinical, educational, and interpersonal behavior. Massage therapists were optimistic regarding the ability of massage to provide a favorable outcome, especially if the desired outcome was supported by research. PMID:24000306

Impaired Maintenance of Interpersonal Synchronization in Musical Improvisations of Patients with Borderline Personality Disorder.

PubMed

Foubert, Katrien; Collins, Tom; De Backer, Jos

2017-01-01

Borderline personality disorder (BPD) is a serious and complex mental disorder with a lifetime prevalence of 5.9%, characterized by pervasive difficulties with emotion regulation, impulse control, and instability in interpersonal relationships and self-image. Impairments in interpersonal functioning have always been a prominent characteristic of BPD, indicating a need for research to identify the specific interpersonal processes that are problematic for diagnosed individuals. Previous research has concentrated on self-report questionnaires, unidirectional tests, and experimental paradigms wherein the exchange of social signals between individuals was not the focus. We propose joint musical improvisation as an alternative method to investigate interpersonal processes. Using a novel, carefully planned, ABA' accompaniment paradigm, and taking into account the possible influences of mood, psychotropic medication, general attachment, and musical sophistication, we recorded piano improvisations of 16 BPD patients and 12 matched healthy controls. We hypothesized that the insecure attachment system associated with BPD would be activated in the joint improvisation and manifest in measures of timing behavior. Results indicated that a logistic regression model, built on differences in timing deviations, predicted diagnosis with 82% success. More specifically, over the course of the improvisation B section (freer improvisation), controls' timing deviations decreased (temporal synchrony became more precise) whereas that of the patients with BPD did not, confirming our hypothesis. These findings are in accordance with previous research, where BPD is characterized by difficulties in attachment relationships such as maintaining strong attachment with others, but it is novel to find empirical evidence of such issues in joint musical improvisation. We suggest further longitudinal research within the field of music therapy, to study how recovery of these timing habits are related to attachment experiences and interpersonal functioning in general.

Impaired Maintenance of Interpersonal Synchronization in Musical Improvisations of Patients with Borderline Personality Disorder

PubMed Central

Foubert, Katrien; Collins, Tom; De Backer, Jos

2017-01-01

Borderline personality disorder (BPD) is a serious and complex mental disorder with a lifetime prevalence of 5.9%, characterized by pervasive difficulties with emotion regulation, impulse control, and instability in interpersonal relationships and self-image. Impairments in interpersonal functioning have always been a prominent characteristic of BPD, indicating a need for research to identify the specific interpersonal processes that are problematic for diagnosed individuals. Previous research has concentrated on self-report questionnaires, unidirectional tests, and experimental paradigms wherein the exchange of social signals between individuals was not the focus. We propose joint musical improvisation as an alternative method to investigate interpersonal processes. Using a novel, carefully planned, ABA′ accompaniment paradigm, and taking into account the possible influences of mood, psychotropic medication, general attachment, and musical sophistication, we recorded piano improvisations of 16 BPD patients and 12 matched healthy controls. We hypothesized that the insecure attachment system associated with BPD would be activated in the joint improvisation and manifest in measures of timing behavior. Results indicated that a logistic regression model, built on differences in timing deviations, predicted diagnosis with 82% success. More specifically, over the course of the improvisation B section (freer improvisation), controls' timing deviations decreased (temporal synchrony became more precise) whereas that of the patients with BPD did not, confirming our hypothesis. These findings are in accordance with previous research, where BPD is characterized by difficulties in attachment relationships such as maintaining strong attachment with others, but it is novel to find empirical evidence of such issues in joint musical improvisation. We suggest further longitudinal research within the field of music therapy, to study how recovery of these timing habits are related to attachment experiences and interpersonal functioning in general. PMID:28496420

A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent.

PubMed

Crowe, Marie; Inder, Maree; Joyce, Peter; Moor, Stephanie; Carter, Janet; Luty, Sue

2009-01-01

This case study explains how a psychotherapy previously used with adults can be used with adolescents by focusing on the specific developmental issues associated with adolescence. Bipolar disorder is a damaging disorder to experience during the developmental phase of adolescence. Interpersonal social rhythm psychotherapy has been developed as an adjunct to medication for managing bipolar disorder and shows some promising outcomes in adults. This is a single case study design drawn from a larger randomised control trial of two psychotherapies for bipolar disorder. The case study addressed the question: How can Interpersonal social rhythm therapy be applied with adolescents who have bipolar disorder? This study used a purposeful sampling process by selecting the youngest adolescent participating in the randomised control trial. All the subject's sessions of Interpersonal social rhythm therapy were taped, transcribed and analysed. The analysis involved describing the process of psychotherapy as it occurred over time, mapping the process as a trajectory across the three phases of psychotherapy experience and focusing the analysis around the impact of bipolar disorder and IPSRT on adolescent developmental issues, specifically the issue of identity development. Interpersonal social rhythm therapy allowed the therapist to address developmental issues within its framework. As a result of participation in the psychotherapy the adolescent was able to manage her mood symptoms and develop a sense of identity that was age-appropriate. Interpersonal social rhythm therapy provided the adolescent in the case study the opportunity to consider what it meant to have bipolar disorder and to integrate this meaning into her sense of self. Bipolar disorder is a chronic and recurring disorder that can have a serious impact on development and functioning. Interpersonal social rhythm therapy provides an approach to nursing care that enables adolescents to improve social functioning.

Exposure to mass media and interpersonal counseling has additive effects on exclusive breastfeeding and its psychosocial determinants among Vietnamese mothers

PubMed Central

Kim, Sunny S.; Nguyen, Tuan T.; Hajeebhoy, Nemat; Tran, Lan M.; Alayon, Silvia; Ruel, Marie T.; Rawat, Rahul; Frongillo, Edward A.; Menon, Purnima

2016-01-01

Abstract The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self‐efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children < 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive's program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors. PMID:27334544

"Out of All of this Mess, I Got a Blessing": Perceptions and Experiences of Reproduction and Motherhood in African American Women Living With HIV.

PubMed

Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Richter, Donna L; Sowell, Richard

2016-01-01

HIV disproportionately impacts African American women of childbearing age residing in the southern United States. Antiretroviral therapy has increased the quantity and quality of life for people living with HIV and produced viable and safe reproduction possibilities for women living with HIV. However, little is known about reproductive decision-making processes for African American women living with HIV. The overall goal of our study was to qualitatively explore perspectives related to reproduction and motherhood in HIV-infected African American women of childbearing capacity. HIV-infected African American women of childbearing capacity in South Carolina (N = 42) participated in in-depth interviews. Our respondents held positive views about pregnancy and motherhood, despite nonsupportive pregnancy messages from interpersonal influences, including health care providers. Study findings uncovered the need for programs and interventions to support women's reproductive autonomy and focus on reducing conception- and pregnancy-related transmission risks to infants and uninfected sexual partners. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Embedding Volunteer Activity into Paramedic Education.

PubMed

Ross, Linda; Kabidi, Sophia

2017-01-01

Paramedics require a wide range of skills that are beyond clinical or technical skills in order to meet the demands of the role and provide quality and compassionate care to patients. Non-technical or "soft" skills and attributes are generally challenging to teach and develop in the classroom setting. Volunteerism provides an opportunity for students to gain exposure to different communities and develop interpersonal skills. This cross-sectional study used one-on-one interviews with 12 third-year Bachelor of Emergency Health (Paramedic) students from Monash University, Australia, who completed a community volunteering program. Results suggest that paramedic students see volunteering as a highly valuable means of developing a number of skills crucial to their future roles and paramedic practice. Volunteering also provided students with an opportunity to learn about themselves and the broader community, develop confidence, and improve overall job-readiness and employability. This study demonstrates that embedding volunteering into paramedic education is an effective way to develop the broad range of paramedic attributes required for the role. These experiences allow students to make the important transition to a job-ready graduate paramedic who can provide holistic patient-centred care.

[Evaluation of the quality of care of transient tachypnea in newborns affiliated with the Medical Insurance Siglo XXI program].

PubMed

Pérez-Cuevas, Ricardo; Jasso Gutiérrez, Luis; Doubova, Svetlana; Flores Hernández, Sergio; Mantilla Trollé, Clara; González Guerra, Eduardo; Muñoz Hernández, Onofre

Evaluation of the quality of care of the newborn with complications is an indispensable element for the improvement of strategies directed to reduce newborn mortality rates. The aim of this work was to evaluate the quality of technical and interpersonal care in the management of transient tachypnea of the newborn (TTN) of patients affiliated with the program "Medical Insurance Siglo XXI". A cross-sectional study was conducted in 61 hospitals affiliated with the Health Ministry with at least two cases of TTN during the first semester of 2011. Variables such as mother's health, pregnancy, birth and birth complication characteristics were analyzed. Also, newborn interventions and health conditions upon discharge were included. To measure the quality of care according to prevention, diagnosis and treatment, quality indicators were defined and validated. We analyzed 256 case files with a diagnosis of TTN; 8.9% of the mothers presented risk factors (asthma, diabetes) and 53.5% had complications during pregnancy. There were 60% of cases with TTN born by cesarean delivery; one third of these children had low birth weight and 14% were transferred to another hospital. As for the quality indicators in the area of prevention, more than 90% of risk factors (smoking, asthma, cesarean delivery) were identified. Diagnostic indicators showed that 86-98% of respiratory distress symptoms were sought. Indicators of treatment achieved satisfactory figures for monitoring and support measures. Prevention, diagnosis and treatment indicators made it possible to consider that most TTN cases received appropriate treatment. It is advisable to develop effective strategies to prevent TTN, such as increasing efforts to reduce the increasing rates of cesarean deliveries. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Employee perspectives on the role of supervisors to prevent workplace disability after injuries.

PubMed

Shaw, William S; Robertson, Michelle M; Pransky, Glenn; McLellan, Robert K

2003-09-01

After workplace injuries, supervisors can play an important role in aiding workers, accessing health care services, and providing reasonable accommodation. However, few studies have identified those aspects of supervisor involvement most valued by employees for postinjury recovery and return to work. As part of needs assessment for a supervisory training program, 30 employees from four companies were interviewed about the role of supervisors to prevent workplace disability after injuries. From interview notes, 305 employee statements were extracted for analysis. An affinity mapping process with an expert panel produced 11 common themes: accommodation, communicating with workers, responsiveness, concern for welfare, empathy/support, validation, fairness/respect, follow-up, shared decision-making, coordinating with medical providers, and obtaining coworker support of accommodation. Interpersonal aspects of supervision may be as important as physical work accommodation to facilitate return to work after injury.

Childhood Abuse and Current Family Conflict: The Role of Shame

PubMed Central

Kim, Jungmeen; Talbot, Nancy L.; Cicchetti, Dante

2014-01-01

Objective To examine whether shame-proneness mediates the relationship between women's histories of childhood sexual abuse and their current partner and family conflict and child maltreatment. Previous research has found that women with childhood sexual abuse histories experience heightened shame and interpersonal conflict. However, research examining the relationship of shame to interpersonal conflict is lacking. Method Participants were 129 mothers of children enrolled in a summer camp program for at-risk children from financially disadvantaged families. Data were collected on women's childhood abuse histories, shame in daily life, and current interpersonal conflict involving family conflict, intimate partner conflict (verbal and physical aggression), and child maltreatment. Results Consistent with our hypothesis, the results of hierarchical regressions and logistic regression indicated that shame significantly mediated the association between childhood sexual abuse and interpersonal conflict. Women with sexual abuse histories reported more shame in their daily lives, which in turn was associated with higher levels of conflicts with intimate partners (self-verbal aggression and partner-physical aggression) and in the family. Shame did not mediate the relationship between mothers' histories of sexual abuse and child maltreatment. Conclusion The role of shame in the intimate partner and family conflicts of women with sexual abuse histories has not been examined. The current findings indicate that childhood sexual abuse was related to interpersonal conflicts indirectly through the emotion of shame. Practical Implications These findings highlight the importance of investigating the role of shame in the interpersonal conflicts of women with histories of childhood sexual abuse. Healthcare professionals in medical and mental health settings frequently treat women with abuse histories who are involved in family and partner conflicts. Assessing and addressing the links of abused women's shame to interpersonal conflicts could be important in clinical interventions. PMID:19457556

'No matter what the cost': A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context.

PubMed

Gott, Merryn; Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

2015-06-01

There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Auckland, New Zealand. Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. © The Author(s) 2015.

Resources for work-related well-being: a qualitative study about healthcare employees' experiences of relationships at work.

PubMed

Schön Persson, Sophie; Nilsson Lindström, Petra; Pettersson, Pär; Nilsson, Marie; Blomqvist, Kerstin

2018-05-23

The aim of this study was to explore municipal healthcare employees' experiences of relationships with care recipients and colleagues. The specific research questions were when do the relationships enhance well-being, and what prerequisites are needed for such relationships to occur?. Employees in health and social care for older people often depict their work in negative terms, and they often take a high number of sick leaves. Despite the heavy workload, other employees express well-being at work and highlight social relationships as one reason for this. However, a greater understanding of how these relationships can act as resources for workplace well-being is needed. The design of the study was qualitative and exploratory. Qualitative interview studies were conducted with twenty-three healthcare employees in municipal healthcare. Thematic analysis was used to analyse the data. Two themes were identified as resources for promoting relationships between employees and care recipients or colleagues: (i) Being personal - a close interpersonal relationship to a care recipient - and (ii) Colleague belongingness - a sense of togetherness within the working group. Spending quality time together, providing long-term care and providing additional care were antecedents for a close interpersonal relationship with care recipients. Trust, mutual responsibility and cooperation were antecedents for a sense of togetherness within the working group. The findings provide an empirical base to raise awareness of relationships with care recipients and colleagues as health aspects. Relationships among employees in healthcare are vital resources that must be considered to create sustainable workplaces, and consequently improve the quality of care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

‘No matter what the cost’: A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context

PubMed Central

Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

2015-01-01

Background: There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. Aim: To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. Design: In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Setting: Auckland, New Zealand. Findings: Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Conclusion: Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. PMID:25680378

The behaviours that dementia care home staff in South Africa find challenging: An exploratory study.

PubMed

van Wyk, Adele; Manthorpe, Jill; Clark, Charlotte

2017-10-01

Background Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion This exploratory study identified care home workers' desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents' distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents' distressed behaviour. Training should be developed in South Africa to promote good practice.

Theory and practice of chaplain's spiritual care process: A psychiatrist's experiences of chaplaincy and conceptualizing trans-personal model of mindfulness

PubMed Central

Parameshwaran, Ramakrishnan

2015-01-01

Background: Of various spiritual care methods, mindfulness meditation has found consistent application in clinical intervention and research. “Listening presence,” a chaplain's model of mindfulness and its trans-personal application in spiritual care is least understood and studied. Aim: The aim was to develop a conceptualized understanding of chaplain's spiritual care process based on neuro-physiological principles of mindfulness and interpersonal empathy. Materials and Methods: Current understandings on neuro-physiological mechanisms of mindfulness-based interventions (MBI) and interpersonal empathy such as theory of mind and mirror neuron system are used to build a theoretical framework for chaplain's spiritual care process. Practical application of this theoretical model is illustrated using a carefully recorded clinical interaction, in verbatim, between chaplain and his patient. Qualitative findings from this verbatim are systematically analyzed using neuro-physiological principles. Results and Discussion: Chaplain's deep listening skills to experience patient's pain and suffering, awareness of his emotions/memories triggered by patient's story and ability to set aside personal emotions, and judgmental thoughts formed intra-personal mindfulness. Chaplain's insights on and ability to remain mindfully aware of possible emotions/thoughts in the patient, and facilitating patient to return and re-return to become aware of internal emotions/thoughts helps the patient develop own intra-personal mindfulness leading to self-healing. This form of care involving chaplain's mindfulness of emotions/thoughts of another individual, that is, patient, may be conceptualized as trans-personal model of MBI. Conclusion: Chaplain's approach may be a legitimate form of psychological therapy that includes inter and intra-personal mindfulness. Neuro-physiological mechanisms of empathy that underlie Chaplain's spiritual care process may establish it as an evidence-based clinical method of care. PMID:25657453

20 CFR 669.680 - What activities and services may be provided under the MSFW youth program?

Code of Federal Regulations, 2010 CFR

2010-04-01

... under the MSFW youth program? 669.680 Section 669.680 Employees' Benefits EMPLOYMENT AND TRAINING... provide activities and services to MSFW youth that include: (1) Intensive services and training services... interpersonal skills development; (3) Community service projects; (4) Small business development technical...

The Impact of Diagnosing Skill Deficiencies and Assessment-Based Communication Training on Managerial Performance.

ERIC Educational Resources Information Center

Papa, Michael J.; Graham, Elizabeth E.

1991-01-01

Evaluates an organizational diagnosis program that assesses managerial communication skills and provides the frame for follow-up training programs. Finds that managers participating in follow-up communication skills training performed significantly higher on interpersonal skills, problem-solving ability, and productivity over three long-term…

Making the Grade: The Importance of Academic Enablers in the Elementary School Counseling Program

ERIC Educational Resources Information Center

Barna, Jennifer S.; Brott, Pamelia E.

2014-01-01

Elementary school counselors can support academic achievement by connecting their comprehensive programs to increasing academic competence. One valuable framework focuses on academic enablers, which are identified as interpersonal skills, motivation, engagement, and study skills (DiPerna, 2004). In this article, the authors (a) discuss the…

The Development of Trust in Residential Environmental Education Programs

ERIC Educational Resources Information Center

Ardoin, Nicole M.; DiGiano, Maria L.; O'Connor, Kathleen; Podkul, Timothy E.

2017-01-01

Trust, a relational phenomenon that is an important building block of interpersonal relationships and within society, can also be an intermediary outcome of field-based environmental education programs. Trust creates a foundation for collaboration and decision-making, which are core to many ultimate outcomes of environmental education. Yet,…

An Overview of Clarkson's Technical Communications Program.

ERIC Educational Resources Information Center

Barkman, Patricia R.

The technical communications program at Clarkson College (New York) offers students 23 courses in subjects ranging from interpersonal behavior to engineering and scientific report writing to computer documentation and the development of technical manuals. With the help of an advisor, each student works out a course of study appropriate to his or…

The Diffusion Of An Innovation: A Case Study Of One Social Studies Program.

ERIC Educational Resources Information Center

Hahn, Carole L.

1985-01-01

Examined what factors were important in the diffusion and adoption of the new social studies program, Toward a Better World. Survey results indicate that media advertisements were ineffective persuaders, while interpersonal communication sources appeared to be more important. Includes tables and references. (TRS)

Case Study of a Service-Learning Partnership: Montana Tech and the Montana State Prison.

ERIC Educational Resources Information Center

Amtmann, John; Evans, Roberta; Powers, Jack

2002-01-01

As a service learning project, Montana Tech students deliver a wellness program for older inmates in Montana State Prison. Outcomes identified in student interviews included improved interpersonal skills (tact, diplomacy, communication, assertiveness) and opportunities to apply knowledge. Students recognized the value of the program for…

Factors influencing the delivery of the fundamentals of care: Perceptions of nurses, nursing leaders and healthcare consumers.

PubMed

Conroy, Tiffany

2017-11-17

To explore the factors described by nurses and consumer representatives influencing the delivery of the fundamentals of care. An ongoing challenge facing nursing is ensuring the "basics" or fundamentals of care are delivered optimally. The way nurses and patients perceive the delivery of the fundamentals of care had not been explored. Once identified, the factors that promote the delivery of the fundamentals of care may be facilitated. Inductive content analysis of scenario based focus groups. A qualitative approach was taken using three stages, including direct observation, focus groups and interviews. This paper reports the second stage. Focus groups discussed four patient care scenarios derived from the observational data. Focus groups were conducted separately for registered nurses, nurses in leadership roles and consumer representatives. Content analysis was used. The analysis of the focus group data resulted in three themes: Organisational factors; Individual nurse or patient factors; and Interpersonal factors. Organisational factors include nursing leadership, the context of care delivery and the availability of time. Individual nurse and patient factors include the specific care needs of the patient and the individual nurse and patient characteristics. Interpersonal factors include the nurse-patient relationship; involving the patient in their care, ensuring understanding and respecting choices; communication; and setting care priorities. Seeking the perspective of the people involved in delivering and receiving the fundamentals of care showed a shared understanding of the factors influencing the delivery of the fundamentals of care. The influence of nursing leadership and the quality of the nurse-patient relationship were perceived as important factors. Nurses and consumers share a common perspective of the factors influencing the delivery of the fundamentals of care and both value a therapeutic nurse-patient relationship. Clinical nursing leaders must understand the impact of their role in shaping the delivery of the fundamentals of care. © 2017 John Wiley & Sons Ltd.

Achieving population-level violence declines: implications of the international crime drop for prevention programming.

PubMed

Eisner, Manuel; Nivette, Amy; Murray, Aja Louise; Krisch, Maria

2016-09-01

The Sustainable Development Goals (SDGs) adopted by the United Nations for the period 2016-2030 aim to achieve a substantial reduction of interpersonal violence. An increasing body of evidence of what works, emerging from randomized controlled trials, can inform public health policy decisions. However, there is very limited evidence on the kinds of mechanisms that lead to sustained declines in interpersonal violence at the population level. We discuss the implications of what is known about recent major declines in violence to guide violence-reduction policies.

[Some reflections on the introduction of family planning into businesses in Cameroon].

PubMed

Ngambi Kunga

1990-01-01

Cameroon has announced that it favors family planning as a means of improving family welfare. In the local context, family planning would refer to spacing and to a lesser extent limiting births, as well as combatting infertility. This work argues that, at a time of deep economic and financial crisis for Cameroon and of growing need and demand for family planning services, the introduction of employment-based family planning services could reinforce the family planning activities of the government and private agencies. The work broadly outlines national family planning policy, identifies weaknesses of proposed family planning strategies, and points out the advantages of employment-based services. Cameroon's infant mortality rate of 90/1000 live births and maternal mortality of 420/100,000 are partly related to its very high fertility rate, closely spaced births, and early pregnancy. The national family planning program goal is to promote health and wellbeing by preventing early and unwanted pregnancies and illnesses in high-risk groups. A decline in unwanted births would be achieved through voluntary use of contraception. The main strategy would be an ambitious IEC program to inform the population of the advantages of family planning using mass media, print materials, and interpersonal communication. The general objectives of the IEC program would be to reduce maternal mortality to 300/100,000 and infant mortality from 90 to 70/1000 and increase contraceptive prevalence from 3 to 20% by 1994. Family planning services and commercial distribution centers would be created, taking advantage of existing health facilities wherever possible as well as community based systems of service delivery for the population not yet served by the traditional distribution system. Experience with the IEC strategy in other countries demonstrates that there is a great disproportion between the population touched by IEC and contraceptive prevalence. The strategy would probably be more effective if it were oriented toward a more limited population group. Interpersonal communication is often a more effective medium for IEC than is communication based on the mass media, and the place of work constitutes an ideal arena for interpersonal communication. An IEC strategy would have more impact in difficult-to-reach rural population if it were reinforced by an employment-based program. Workers as a group are more disposed to conscious decision making about family sizes than are other categories of persons. Employment-based services could benefit workers, their spouses, and perhaps the neighboring population. Employers would benefit from the improved health of the workers, from the greater continuity of employment of female workers not requiring maternity leaves, and from lessened expenditures related to the family size of the workforce, such as health care costs. A cost-benefit analysis of an employment-based family planning would demonstrate the savings to be realized by the program, especially over time.

Psychological, interpersonal, and behavioral correlates of chronic self-destructiveness: an exploratory study.

PubMed

Boudewyn, A C; Liem, J H

1995-12-01

In this study, we selected individuals high and low on a measure of chronic self-destructiveness--the tendency to perform behaviors that later reduce positive consequences and increase the probability of experiencing negative ones--and attempted to differentiate high and low scorers based on a set of hypothesized antecedent and concurrent psychological, interpersonal, and behavioral correlates. Men and women were equally represented in high- and low-scoring groups. High scorers reported experiencing more interpersonal exploitation, greater depression, lower self-esteem, more externalizing attitudes, and less control in relationships than low scorers. High-scoring individuals also engaged in more frequent acts of acute self-destructiveness, including attempted suicide. A significant age covariate effect emerged: high-scoring men and women were younger than low-scoring individuals. These findings underscore the importance of studying chronic self-destructiveness within a developmental framework and suggest that issues of safety and self-care may be particularly germane to educational and clinical interventions aimed at young adults.

[Reducing occupational burnout and enhancing job performance in new nurses: the efficacy of "last mile" programs].

PubMed

Wu, Hsiu-Mei; Liu, Pei-Fen; Ho, Hsueh-Hua; Chen, Ping-Ling; Chao, Hui-Lin; Chen, Hsiao-Lien

2012-08-01

New nurses undergo a stressful and challenging transition process in the nursing workplace. Lack of patient care knowledge and skills and work adaption difficulties lead to a high turnover rate that drains essential new talent away from the nursing profession and further exacerbates professional staffing shortages in the healthcare sector. The "last mile" program is a program developed jointly by a nursing school and hospital as a mechanism to bridge classroom learning to clinical practice and smooth the transition of nursing students into nursing professionals. The purpose of this study was to understand the effect of the "last mile" program on job performance and occupational burnout among new nurses. We conducted a quasi-experimental study in 2009 on a convenience sample of new nurses in a medical center. Participants were assigned into two groups, namely those enrolled in the last mile program (n = 29) and those not enrolled in the program (n = 94). Research team members and several collaborative universities developed the last mile program used in this study; Seven experts established content validity; The last mile program included 84 hours of lecture courses and 160 hours of clinical practice. Data was collected using the nursing job performance scale developed in 2007 by Greenslade and Jimmieson and translated ÷ back translated into an equivalent Chinese version. Exploratory factor analysis showed all items aggraded into 8 factors, which could be divided into task performance and contextual performance concept categories. Task performance concepts included: social support, information, coordination of care, and technical care; Contextual performance concepts included: interpersonal support, job-task support, volunteering for additional duties and compliance. The Cronbach's α for the 8 factors were .70-.95. The occupational burnout inventory included the 4 subscales of personal burnout, work-related burnout, client-related burnout, and over-commitment, with associated Cronbach's α ranging from .84-.90. Data was collected at one, three, and six months after employment. Repeated measures ANOVA and an independent t-test were used to analyze data. The average age of the 123 participants surveyed was 23 years, with no differences identified between last-mile and non-last-mile groups in terms of education level, work unit, or other demographic variables. New nurses who participated in the last mile program achieved significantly higher performance scores for job-task support, volunteering for additional duties, and overall task and contextual performance than those who did not. Last-mile-program group participants also had significantly lower client-related burnout than their non-last-mile-program peers. The last mile program facilitates new nurses' contextual performance and reduces incidence of care burnout. The cooperative education model linking universities and hospitals can be a positive component in a new nurse retention strategy for hospital administrators and educators.

Video concepts in CRM training

NASA Technical Reports Server (NTRS)

Yocum, M.

1984-01-01

Cockpit resource management (CRM) is discussed in the context of programs developed by Pennsylvania Airlines and Ransome Airlines. Video techniques in flight training are emphasized. Problems in cockpit interpersonal communication are addressed.

"We Do Care," Say Parents

ERIC Educational Resources Information Center

Mistretta, Regina M.

2013-01-01

Parents can positively impact children's learning of mathematics. To productively engage families in the learning process, teachers must support such interpersonal relationships. The author describes the investigative work of a group of teacher candidates as they sought to attain such understanding. Eighteen preservice teachers, who were…

Effective Personnel Management. The 1980 Regional Meeting NACS Traveling Troupe Presentation.

ERIC Educational Resources Information Center

Arnett, Wayne; Williams, James L.

1981-01-01

Specific suggestions are given for more effective personnel management: careful screening of applicants by one person, a well-designed application form (a sample is provided), good interview techniques, job descriptions, promotions from within, employee manuals, employee orientation, and continuing interpersonal communication. (MSE)

Explorations in Personal Health.

ERIC Educational Resources Information Center

Haro, Michael S.; And Others

This text, designed for college students, is oriented toward the social, emotional, and behavioral aspects of health. Eight health-related topics of major concern for college students were selected for inclusion: (1) interpersonal relationships; (2) coping strategies; (3) sexuality; (4) nutrition; (5) medical care and services; (6) health…

The Grim Reaper, Hounds of Hell, and Dr. Death: The Role of Storytelling for Palliative Care in Competing Medical Meaning Systems.

PubMed

Omilion-Hodges, Leah M; Swords, Nathan M

2017-10-01

Palliative care (PC) is a medical specialty that strives to fulfill the physical, psychosocial, emotional, practical, and spiritual needs of individuals at end of life or in tandem with curative treatment. Although exponentially rising in use and beneficial to patient well-being at end of life, the purpose of PC is often misunderstood and those providing its services frequently report resistance from organizational members. Such resistance can be attributed to tensions between traditional biomedical models of medicine that privilege curative treatment and biosocial models of medicine that holistically care for patients. Thus, this study addresses what tensions PC providers experience in their institutions and what communicative strategies they use at the interpersonal level in managing those tensions. Using structuration theory in tandem with relational dialectics theory, we inductively analyzed semistructured interviews with 24 Circle of Life award-winning PC providers. Findings indicate two dialectics experienced by PC providers in their institutions: the living-dying dialectic and the practicing-advocating dialectic. We conclude that these interpersonal dialectics emerge through interaction in competing medical meaning systems and found that storytelling was a particularly salient form of communication that participants used for management.

Voices That Care: Licensed Practical Nurses and the Emotional Labour Underpinning Their Collaborative Interactions with Registered Nurses

PubMed Central

Huynh, Truc; Alderson, Marie; Nadon, Michelle; Kershaw-Rousseau, Sylvia

2011-01-01

Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPN's emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs. PMID:22135732

[Interpersonal therapy (IPT) in child psychiatry and adolescent].

PubMed

Lavigne, B; Audebert-Mérilhou, E; Buisson, G; Kochman, F; Clément, J P; Olliac, B

2016-12-01

Depression disorder may become the first cause of morbidity by 2030, according to the World Health Organization. It is actually one of the main causes of disease and handicap in children aged from 10 to 19. The major risk is suicide, whose prevalence is estimated, in France, around 6.7 for 100,000, which is probably underestimated. At present, the discussions about prescription of antidepressants in an adolescent's depression remain intense which is why psychotherapy becomes the first choice of treatment. We propose here to present one of them, Interpersonal PsychoTherapy (IPT), which remains largely unknown in France, and its adaptations in the adolescent population. IPT is a brief psychotherapy, structured in twelve to sixteen sessions, which was created by Klerman and Weissman in the seventies inspired by the biopsychosocial model of Meyer, interpersonal theory of Sullivan, and attachment theory of Bowlby. It is divided into three parts: the initial phase, the intermediate phase, and the termination phase. IPT was adapted for adolescents by Mufson in 1993, but a few modifications must be considered. Parental implication is the first. Indeed, parents, rather than the adolescent, often ask for the consultation; but it is the latter who benefits from the therapy. Parents may be met at some point in the therapy, for example between each phase and at the end. The initial phase is very close for the adolescent as for the adult; but the therapist must be careful about employing the "sick role" which can be used by the adolescent to avoid school, and as a consequence, to exacerbate the interpersonal deficit. The intermediate phase focuses on one of the four interpersonal issues: complicated bereavement, role transition, interpersonal role disputes, and interpersonal deficit. Complicated bereavement may become problematic when prolonged or when the adolescent had complicated relations with the deceased. The therapist essentially works on emotion verbalization. The role of transition is very common during adolescence: children become adults, they pass from high school to college, or their parents get divorced, etc. The patient and the therapist work on giving up the old role with its emotional expression (guilt, anger, and loss), and acquiring new skills, and identifying positive aspects of the new role. Interpersonal role disputes are common during adolescence, with parents or teachers for example. To determine a treatment plan, the therapist may first determine the stage of the role dispute, among impasse, renegotiation, or dissolution, and then work on the communication mode of the patient. At the least, the interpersonal deficit may be the most difficult area to work on because of the risk of psychiatric comorbidity. The therapist must be especially careful about anxious disorder which may complicate the psychotherapy and for which IPT is not the best therapy. The termination phase focuses on the new skills and abilities and works on the future without therapy. IPT is one of the psychotherapies recommended in the treatment of depression disorder in the international recommendations. But in France, all psychotherapies are considered equally. This may be a consensual approach, but the authors wonder if it is the best, especially to motivate research in the psychotherapy field. Finally, IPT has been developed in other indications in the past years, and many others are presently in research projects: depression during pregnancy, prevention of depression relapse, eating disorders, attention deficit and hyperactivity disorder, self-harm for example. Its validity, simplicity and efficacy should stimulate psychiatrists and residents to train themselves to IPT. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum.

PubMed

Russ-Sellers, Rebecca; Blackwell, Thomas H

2017-07-01

Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

Remote access and care: A comparison of Queensland women's maternity care experience according to area of residence.

PubMed

Hennegan, Julie; Kruske, Sue; Redshaw, Maggie

2014-12-01

This study fills a gap in the literature with a quantitative comparison of the maternity care experiences of women in different geographic locations in Queensland, Australia. Data from a large-scale survey were used to compare women's care experiences according to Australian Standard Geographical Classification (major city, inner regional, outer regional, remote and very remote). Compared to the other groups, women from remote or very remote areas were more likely to be younger, live in an area with poorer economic resources, identify as Aboriginal and/or Torres Strait Islander and give birth in a public facility. They were more likely to travel to another city, town or community for birth. In adjusted analyses women from remote areas were less likely to have interventions such as electronic fetal monitoring, but were more likely to give birth in an upright position and be able to move around during labour. Women from remote areas did not differ significantly from women from major cities in their satisfaction with interpersonal care. Antenatal and postpartum care was lacking for rural women. In adjusted analyses they were much less likely to have booked for maternity care by 18 weeks gestation, to be telephoned or visited by a care provider in the first 10 days after birth. Despite these differences, women from remote areas were more likely to be breastfeeding at 13 weeks and confident in caring for their baby at home. Findings support qualitative assertions that remote and rural women are disadvantaged in their access to antenatal and postnatal care by the need to travel for birth, however, other factors such as age were more likely to be significant barriers to high quality interpersonal care. Improvements to maternity services are needed in order to address inequalities in maternity care particularly in the postnatal period. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Improving Empathy and Communication Skills of Visually Impaired Early Adolescents through a Psycho-Education Program

ERIC Educational Resources Information Center

Yildiz, Mehmet Ali; Duy, Baki

2013-01-01

The purpose of this study was to investigate the effectiveness of an interpersonal communication skills psycho-education program to improve empathy and communication skills of visually impaired adolescents. Participants of the study were sixteen early adolescents schooling in an elementary school for visually impaired youth in Diyarbakir. The…

Making a Difference in Learners' Lives: Results of a Study Based on Adult Literacy Programs

ERIC Educational Resources Information Center

Terry, Marion

2006-01-01

Using qualitative methods, the author explores how adult learners' lives are affected by participating in adult literacy programs in Manitoba, Canada. After a description of research methods, changes in six major areas of learners' lives are discussed: general attitudes toward life, levels of interpersonal awareness, self-esteem, academic…

Developing Enlightened Leaders for Industry and Community: Executive Education and Service-Learning

ERIC Educational Resources Information Center

Rhee, Kenneth S.; Sigler, Tracey Honeycutt

2010-01-01

What does it take to develop enlightened leaders who can transform their organizations and communities? The quest to develop enlightened leaders who are self-aware, learning centered, adaptable, interpersonally competent, and team oriented is a challenge faced by many management programs. The Master of Science program in Executive Leadership and…

Interpersonal Process Group Counseling for Educationally Marginalized Youth: The MAGNIFY Program

ERIC Educational Resources Information Center

Slaten, Christopher D.; Elison, Zachary M.

2015-01-01

Youth mental health is an area of profound disparity between the demand and supply of services, particularly in schools that serve students at risk of school dropout. This article describes the conceptual foundations and implementation of "MAGNIFY", a program that provides free group counseling to small alternative schools with students…

Building a Foundation against Violence: Impact of a School-Based Prevention Program on Elementary Students

ERIC Educational Resources Information Center

Hall, Bruce W.; Bacon, Tina P.

2005-01-01

This study examined the effectiveness of the Too Good for Violence Prevention Program (TGFV), a multifaceted interactive intervention. Grounded in Bandura's Social Learning Theory, the TGFV curricula focus on developing personal and interpersonal skills to solve conflict non-violently and resist social influences that lead to violence.…

The Effect of Neurolinguistic Programming on Organisational and Individual Performance: A Case Study.

ERIC Educational Resources Information Center

Thompson, John E.; Courtney, Lisa; Dickson, D.

2002-01-01

A longitudinal evaluation measured the effects of neurolinguistic programming (NLP) on 67 hospitality worker immediately before and after and 6 weeks and 6 months after training. Positive increases in interpersonal communication appeared after 6 weeks, leveling off or declining after 6 months. Self-efficacy, self-esteem, and adaptive selling…

Development of four self-report measures of job stressors and strain: Interpersonal Conflict at Work Scale, Organizational Constraints Scale, Quantitative Workload Inventory, and Physical Symptoms Inventory.

PubMed

Spector, P E; Jex, S M

1998-10-01

Despite the widespread use of self-report measures of both job-related stressors and strains, relatively few carefully developed scales for which validity data exist are available. In this article, we discuss 3 job stressor scales (Interpersonal Conflict at Work Scale, Organizational Constraints Scale, and Quantitative Workload Inventory) and 1 job strain scale (Physical Symptoms Inventory). Using meta-analysis, we combined the results of 18 studies to provide estimates of relations between our scales and other variables. Data showed moderate convergent validity for the 3 job stressor scales, suggesting some objectively to these self-reports. Norms for each scale are provided.

Evaluative Assessment for NASA/GSFC Equal Opportunity Programs Office Sponsored Programs

NASA Technical Reports Server (NTRS)

Jarrell, H. Judith

1995-01-01

The purpose of PREP (Pre-College Minority Engineering Program) is to upgrade skills of minority students who have shown an interest in pursuing academic degrees in electrical engineering. The goal is to upgrade skills needed for successful completion of the rigorous curriculum leading to a Bachelor of Science degree in engineering through a comprehensive upgrade of academic, study and interpersonal skills.

Student Behaviour Problems: Context, Initiatives and Programs. Selected Papers from the National Conference on Student Behaviour Problems: Context, Initiatives and Programs (3rd, Brisbane, Queensland, Australia, October 1991).

ERIC Educational Resources Information Center

Elkins, John, Ed.; Izard, John, Ed.

The conference papers in this collection are grouped under the following topics: behavior problems in context; interpersonal relationships; initiatives by systems and schools; and programs in special settings. Papers included are: (1) National Trends in Discipline Policy Development (Roger Slee); (2) Balancing: The Protocols of Discipline (William…

Maintenance of Certification for Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kun, Larry E.; Ang, Kian; Erickson, Beth

2005-06-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements ofmore » the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development.« less

Exposure to mass media and interpersonal counseling has additive effects on exclusive breastfeeding and its psychosocial determinants among Vietnamese mothers.

PubMed

Nguyen, Phuong H; Kim, Sunny S; Nguyen, Tuan T; Hajeebhoy, Nemat; Tran, Lan M; Alayon, Silvia; Ruel, Marie T; Rawat, Rahul; Frongillo, Edward A; Menon, Purnima

2016-10-01

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children < 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive's program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

A Grounded Theory Study of the Mentoring Process Involved With Undergraduate Athletic Training Students

PubMed Central

Pitney, William A; Ehlers, Greg G

2004-01-01

Objective: To gain insight regarding the mentoring processes involving students enrolled in athletic training education programs and to create a mentoring model. Design and Setting: We conducted a grounded theory study with students and mentors currently affiliated with 1 of 2 of the athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs. Participants: Sixteen interviews were conducted, 13 with athletic training students and 3 with individuals identified as mentors. The students ranged in age from 20 to 24 years, with an average of 21.6 years. The mentors ranged from 24 to 38 years of age, with an average of 33.3 years. Participants were purposefully selected based on theoretic sampling and availability. Data Analysis: The transcribed interviews were analyzed using open-, axial-, and selective-coding procedures. Member checks, peer debriefings, and triangulation were used to ensure trustworthiness. Results: Students who acknowledged having a mentor overwhelmingly identified their clinical instructor in this role. The open-coding procedures produced 3 categories: (1) mentoring prerequisites, (2) interpersonal foundations, and (3) educational dimensions. Mentoring prerequisites included accessibility, approachability, and protégé initiative. Interpersonal foundations involved the mentor and protégé having congruent values, trust, and a personal relationship. The educational dimensions category involved the mentor facilitating knowledge and skill development, encouraging professional perspectives, and individualizing learning. Although a student-certified athletic trainer relationship can be grounded in either interpersonal or educational aspects, the data support the occurrence of an authentic mentoring relationship when the dimensions coalesced. Conclusions: Potential mentors must not only be accessible but also approachable by a prospective protégé. Mentoring takes initiative on behalf of a student and the mentor. A mentoring relationship is complex and involves the coalescence of both interpersonal and educational aspects of an affiliation. As a professional-socialization tactic, mentoring offers students a way to anticipate the future professional role in a very personal and meaningful way. PMID:15592607

34 CFR 373.4 - What definitions apply?

Code of Federal Regulations, 2013 CFR

2013-07-01

... requirements for “an individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable... (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or... be active, full partners in the rehabilitation process, making meaningful and informed choices as...

34 CFR 373.4 - What definitions apply?

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirements for “an individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable... (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or... be active, full partners in the rehabilitation process, making meaningful and informed choices as...

34 CFR 373.4 - What definitions apply?

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirements for “an individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable... (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or... be active, full partners in the rehabilitation process, making meaningful and informed choices as...

34 CFR 373.4 - What definitions apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirements for “an individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable... (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or... be active, full partners in the rehabilitation process, making meaningful and informed choices as...

34 CFR 373.4 - What definitions apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for “an individual with a disability” in section 7(20)(c) through (e) of the Act, as applicable... (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or... be active, full partners in the rehabilitation process, making meaningful and informed choices as...

Health Services Assistant. Revised. Instructor Guide.

ERIC Educational Resources Information Center

Missouri Univ., Columbia. Instructional Materials Lab.

This color-coded curriculum guide was developed to help health services educators prepare students for health services occupations. The curriculum is organized in 20 units that cover the following topics: interpersonal relationships and the health care team; communication and observation skills; safety considerations; microbiology; the body as a…

Gathering Sensitive Stories

ERIC Educational Resources Information Center

Daley, Kathryn

2012-01-01

Discussions of research ethics are often focused on research ethics guidelines. These guidelines are useful in designing ethical research projects but are not designed to guide the interpersonal interactions that occur once researchers are out in the field. Drawing from Noddings' care theory, this article argues that making ethical decisions when…

Outcome of intensive inpatient treatment for combat-related posttraumatic stress disorder.

PubMed

Johnson, D R; Rosenheck, R; Fontana, A; Lubin, H; Charney, D; Southwick, S

1996-06-01

This study analyzed the outcome of a 4-month intensive inpatient program for combat-related posttraumatic stress disorder (PTSD) among Vietnam veterans. The subjects were 51 male veterans with PTSD who completed the inpatient treatment program. Comprehensive measures of PTSD and psychiatric symptoms, as well as social functioning, were assessed at admission, discharge, and 6, 12, and 18 months after discharge. The overall study group showed an increase in symptoms from admission to follow-up and a decrease in violent actions and thoughts and legal problems. Family and interpersonal relationships and overall morale were improved at discharge but then returned to pretreatment levels at 18 months. Patient evaluations also indicated that the program affected morale and interpersonal relationships but not symptoms. The chronic nature of combat-related PTSD among Vietnam veterans is evident. The study raises the possibility that long-term intensive inpatient treatment is not effective, and other forms of treatment should be considered after rigorous study of such variables as length of stay, trauma versus rehabilitation focus, and patient characteristics.

Quality and comparison of antenatal care in public and private providers in the United Republic of Tanzania.

PubMed Central

Boller, Christoph; Wyss, Kaspar; Mtasiwa, Deo; Tanner, Marcel

2003-01-01

OBJECTIVE: To compare the quality of public and private first-tier antenatal care services in Dar es Salaam, United Republic of Tanzania, using defined criteria. METHODS: Structural attributes of quality were assessed through a checklist, and process attributes, including interpersonal and technical aspects, through observation and exit interviews. A total of 16 health care providers, and 166 women in the public and 188 in the private sector, were selected by systematic random sampling for inclusion in the study. Quality was measured against national standards, and an overall score calculated for the different aspects to permit comparison. FINDINGS: The results showed that both public and private providers were reasonably good with regard to the structural and interpersonal aspects of quality of care. However, both were poor when it came to technical aspects of quality. For example, guidelines for dispensing prophylactic drugs against anaemia or malaria were not respected, and diagnostic examinations for the assessment of gestation, anaemia, malaria or urine infection were frequently not performed. In all aspects, private providers were significantly better than public ones. CONCLUSION: Approaches to improving quality of care should emerge progressively as a result of regular quality assessments. Changes should be introduced using an incremental approach addressing few improvements at a time, while ensuring participation in, and ownership of, every aspect of the strategy by health personnel, health planners and managers and also the community. PMID:12751419

Project PAVE (Personality And Vision Experimentation): role of personal and interpersonal resilience in the perception of emotional facial expression

PubMed Central

Tanzer, Michal; Shahar, Golan; Avidan, Galia

2014-01-01

The aim of the proposed theoretical model is to illuminate personal and interpersonal resilience by drawing from the field of emotional face perception. We suggest that perception/recognition of emotional facial expressions serves as a central link between subjective, self-related processes and the social context. Emotional face perception constitutes a salient social cue underlying interpersonal communication and behavior. Because problems in communication and interpersonal behavior underlie most, if not all, forms of psychopathology, it follows that perception/recognition of emotional facial expressions impacts psychopathology. The ability to accurately interpret one’s facial expression is crucial in subsequently deciding on an appropriate course of action. However, perception in general, and of emotional facial expressions in particular, is highly influenced by individuals’ personality and the self-concept. Herein we briefly outline well-established theories of personal and interpersonal resilience and link them to the neuro-cognitive basis of face perception. We then describe the findings of our ongoing program of research linking two well-established resilience factors, general self-efficacy (GSE) and perceived social support (PSS), with face perception. We conclude by pointing out avenues for future research focusing on possible genetic markers and patterns of brain connectivity associated with the proposed model. Implications of our integrative model to psychotherapy are discussed. PMID:25165439

Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling.

PubMed

Chiesa, Marco; Fonagy, Peter; Bateman, Anthony W

2007-12-01

Although several studies have described patient populations in primary care counselling settings and NHS (National Health Service) specialist psychotherapy settings, there is a paucity of studies specifically comparing differences in clinical characteristics between the two groups of patients. The aim of this study is to ascertain if specialist psychotherapy referrals represent a more challenging client group than primary care counselling patients. We compare the socio-demographic features and severity of presentation in the symptomatic, interpersonal problems and global adjustment dimensions of a sample of patients (N=384) assessed by a primary care counselling service located in North London and a sample of patients (N=853) assessed in eight NHS psychotherapy centres located within urban settings in England. Both the groups completed the Brief Symptom Inventory, the Inventory of Interpersonal Problems and Clinical Outcomes in Routine Evaluation Outcome Measure. Patients referred for specialist psychotherapy services were more dysfunctional than those referred for primary care counselling. The linear function constructed to discriminate the groups showed that a combination of more psychotic symptoms, social inhibitions and higher risk of self-harm effectively identified those referred to psychotherapy services, while patients exhibiting greater levels of somatic and anxiety symptoms and non-assertiveness were more likely to be seen in primary care settings. However, similarities between the two samples were also marked, as shown by the overlap in the distribution of clinical outcomes in routine evaluation clinical scores in the two samples. The findings are discussed in terms of their implications for policy and service delivery of these two types of psychological therapy services.

Professional communication competences of physiotherapists -- practice and educational perspectives.

PubMed

Włoszczak-Szubzda, Anna; Jarosz, Mirosław J

2013-01-01

Dissonance between the high 'technical' competences of medical professionals, including physiotherapists, and the relatively low level of patient satisfaction with care received is a phenomenon observed in many countries. Many studies show that it occurs in the case of an inadequate interpersonal communication between medical professionals and patients. The primary goal of the presented research was evaluation of the level (study of the state) of communication competences of physiotherapists, and determination of the factors on which this level depends. An additional goal was analysis of the needs and educational possibilities within the existing models of education in the area of interpersonal communication provided by higher medical education institutions. The self-designed questionnaire and adjective check list were subject to standardization from the aspect of reliability and validity. Information available on the websites of 20 educational facilities in Poland were compared. The study group covered a total number of 115 respondents in the following subgroups: 1) occupationally-active physiotherapists who, as a rule, were not trained in interpersonal communication (35 respondents); students of physiotherapy covered by a standard educational programme (60 respondents); 3) students of physiotherapy who, in addition to a standard educational programme, attended extra courses in professional interpersonal communications (20 respondents). The results of studies indicate poor efficacy of shaping communication competences of physiotherapists based on education in the area of general psychology and general interpersonal communication. Communication competences acquired during undergraduate physiotherapy education are subject to regression during occupational activity. Methods of evaluating communication competences are useful in constructing group and individual programmes focused on specific communication competences, rather than on general communication skills.

Fair and Just Culture, Team Behavior, and Leadership Engagement: The Tools to Achieve High Reliability

PubMed Central

Frankel, Allan S; Leonard, Michael W; Denham, Charles R

2006-01-01

Background Disparate health care provider attitudes about autonomy, teamwork, and administrative operations have added to the complexity of health care delivery and are a central factor in medicine's unacceptably high rate of errors. Other industries have improved their reliability by applying innovative concepts to interpersonal relationships and administrative hierarchical structures (Chandler 1962). In the last 10 years the science of patient safety has become more sophisticated, with practical concepts identified and tested to improve the safety and reliability of care. Objective Three initiatives stand out as worthy regarding interpersonal relationships and the application of provider concerns to shape operational change: The development and implementation of Fair and Just Culture principles, the broad use of Teamwork Training and Communication, and tools like WalkRounds that promote the alignment of leadership and frontline provider perspectives through effective use of adverse event data and provider comments. Methods Fair and Just Culture, Teamwork Training, and WalkRounds are described, and implementation examples provided. The argument is made that they must be systematically and consistently implemented in an integrated fashion. Conclusions There are excellent examples of institutions applying Just Culture principles, Teamwork Training, and Leadership WalkRounds—but to date, they have not been comprehensively instituted in health care organizations in a cohesive and interdependent manner. To achieve reliability, organizations need to begin thinking about the relationship between these efforts and linking them conceptually. PMID:16898986

Trust in technology-mediated collaborative health encounters: constructing trust in passive user interactions with technologies.

PubMed

Montague, Enid; Asan, Onur

2012-01-01

The present study investigated factors that explain patient trust in health technology and the relationship between patient trust in technology and trust in their care provider. Sociotechnical systems theory states that changes in one part of the system are likely related to other parts of the system. Therefore, attitudes about technologies, like trust, are likely related to other aspects of the system. Contributing to appropriate trust at the technological, interpersonal, and system levels can potentially lead to positive health outcomes. The study described in this manuscript used data collected from 101 patients with a Trust in Medical Technology instrument. The instrument measured patients' trust in (1) their providers, (2) the technology, and (3) how their providers used the technology. Measure 3 was positively associated with measures 1 and 2, while measures 1 and 2 were not positively or negatively associated with one another. These results may indicate that patient assessments of the trustworthiness of care providers and technologies are based on their observations of how providers use technologies. Though patients are not active users of technologies in health care, the results of this study show that their perceptions of how providers use technology are related to their trust in both technology and the care provider. Study findings have implications for how trust is conceptualised and measured in interpersonal relationships and in technologies.

Parenting and physical punishment: primary care interventions in Latin America.

PubMed

López Stewart, C; Lara, M G; Amighetti, L D; Wissow, L S; Gutierrez, M I; Levav, I; Maddaleno, M

2000-10-01

Physical punishment is a form of intrafamilial violence associated with short- and long-term adverse mental health outcomes. Despite these possible consequences, it is among the most common forms of violent interpersonal behavior. For many children it begins within the first year of life. The goal of this study was to determine the feasibility of involving public sector primary health care providers to inform parents about alternatives to physical punishment. The study used a qualitative design utilizing focus groups and survey questionnaires with parents and providers at six clinic sites chosen to be representative of public sector practice settings in Costa Rica and in metropolitan Santiago, Chile. The data were collected during 1998 and 1999. In the focus groups and surveys the parents voiced a range of opinions about physical punishment. Most acknowledged its common use but listed it among their least preferred means of discipline. Frequency of its use correlated positively with the parents' belief in its effectiveness and inversely with their satisfaction with their children's behavior. Some parents wanted to learn more about discipline; others wanted help with life stresses they felt led them to use physical punishment. Parents reported they chose other family members more frequently as a source of parenting information than they did health care providers. Some parents saw providers as too rushed and not knowledgeable enough to give good advice. Providers, in turn, felt ill equipped to handle parents' questions, but many of the health professionals expressed interest in more training. Parents and providers agreed that problems of time, space, and resources were barriers to talking about child discipline in the clinics. Many parents and providers would welcome a primary-care-based program on physical punishment. Such a program would need to be customized to accommodate local differences in parent and provider attitudes and in clinic organization. Health care professionals need more training in child discipline and in the skills required to interact with parents on issues relating to child behavior.

A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program.

PubMed

Vellakkal, Sukumar; Reddy, Hanimi; Gupta, Adyya; Chandran, Anil; Fledderjohann, Jasmine; Stuckler, David

2017-04-01

Not all eligible women use the available services under India's Janani Suraksha Yojana (JSY), which provides cash incentives to encourage pregnant women to use institutional care for childbirth; limited evidence exists on demand-side factors associated with low program uptake. This study explores the views of women and ASHAs (community health workers) on the use of the JSY and institutional delivery care facilities. In-depth qualitative interviews, carried out in September-November 2013, were completed in the local language by trained interviewers with 112 participants consisting of JSY users/non-users and ASHAs in Jharkhand, Madhya Pradesh and Uttar Pradesh. The interaction of impeding and enabling factors on the use of institutional care for delivery was explored. We found that ASHAs' support services (e.g., arrangement of transport, escort to and support at healthcare facilities) and awareness generation of the benefits of institutional healthcare emerged as major enabling factors. The JSY cash incentive played a lesser role as an enabling factor because of higher opportunity costs in the use of healthcare facilities versus home for childbirth. Trust in the skills of traditional birth-attendants and the notion of childbirth as a 'natural event' that requires no healthcare were the most prevalent impeding factors. The belief that a healthcare facility would be needed only in cases of birth complications was also highly prevalent. This often resulted in waiting until the last moments of childbirth to seek institutional healthcare, leading to delay/non-availability of transportation services and inability to reach a delivery facility in time. ASHAs opined that interpersonal communication for awareness generation has a greater influence on use of institutional healthcare, and complementary cash incentives further encourage use. Improving health workers' support services focused on marginalized populations along with better public healthcare facilities are likely to promote the uptake of institutional delivery care in resource-poor settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Exploring interpersonal behavior and team sensemaking during health information technology implementation.

PubMed

Kitzmiller, Rebecca R; McDaniel, Reuben R; Johnson, Constance M; Lind, E Allan; Anderson, Ruth A

2013-01-01

We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project. Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens. We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger. Leaders must enact voice-promoting behaviors and use them throughout a team's engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation. Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking. Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes. We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders' behaviors might facilitate or impeded speaking up among project teams in health care settings.

Self-transcendence and nurse-patient interaction in cognitively intact nursing home patients.

PubMed

Haugan, Gørill; Rannestad, Toril; Hanssen, Brith; Espnes, Geir A

2012-12-01

The aim of this study was to test whether nurse-patient interaction affects cognitively intact nursing home patients' interpersonal and intrapersonal self-transcendence, as well as testing the psychometric properties of the Nurse-Patient Interaction Scale (NPIS). Self-transcendence is considered a spiritual developmental process of maturity in adulthood, and a vital resource of well-being at the end of life. The concept of self-transcendence has previously been explored in various populations, yet the nurse-patient interactions' potential influence on self-transcendence in nursing home patients has not been published previously. A cross-sectional design employing the Self-Transcendence Scale and the NPIS was adopted. A sample of 202 cognitively well-functioning nursing home patients in Norway was selected. The statistical analyses were carried out using lisrel 8.8 and structural equation modelling. Structural equation modelling-analysis indicates statistical significant effect of nurse-patient interaction on the patients' self-transcendence. Direct influence on the intrapersonal and indirect influence on the interpersonal self-transcendence aspects was disclosed. Nurse-patient interaction significantly affected both interpersonal and intrapersonal self-transcendence among cognitively intact nursing home patients. Hence, facilitating caring interventions can be significantly beneficial to older patients' self-transcendence and thereby well-being, both emotional and physical. Caring behaviour signifies the vital and ultimate qualitative nursing behaviour, which promotes self-transcendence and thereby well-being. These findings are important for clinical nursing that intends to increase patients' well-being. © 2012 Blackwell Publishing Ltd.

A Process Model of Family Formation and Development

ERIC Educational Resources Information Center

Garland, Diana R.

2012-01-01

Theoretical models of family formation have assumed sexual coupling as the foundation of family life. This article proposes instead a model of family formation predicated on the processes of taking care of one another, eating together, and sharing life together. The interpersonal dynamics that distinguish a family from other close relationships…

25 CFR 20.100 - What definitions clarify the meaning of the provisions of this part?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., economic, psychological, interpersonal, and/or other problems, to achieve self-sufficiency and independence... experience and training. Foster care services means those social services provided to an eligible Indian...-governance annual funding agreement, which provides eligible participants with work experience and training...

The ideal physician: implications for contemporary hospital marketing.

PubMed

Gochman, D S; Stukenborg, G J; Feler, A

1986-06-01

A questionnaire asking individuals to identify freely the characteristics most descriptive of physicians who are closest to their ideal was mailed to a systematically derived cluster sample in a medium-size metropolitan area. Respondents clearly valued psychosocial and interpersonal characteristics such as communicating and caring much more than technical medical skills.

Anthropology for Contemporary Nurses: A Paper for Consideration.

ERIC Educational Resources Information Center

Clavner, Jerry B.; Sumodi, Veronica R.

The integration of culturally relevant concepts into nursing education is essential for the effective delivery of health care in a modern, multi-ethnic, multi-racial, mobile society. Several key concepts from anthropology and specific areas of individual interpersonal behavior have particular relevance to nursing education. It is important, for…

Who Cares? Revisiting Empathy in Asperger Syndrome

ERIC Educational Resources Information Center

Rogers, Kimberley; Dziobek, Isabel; Hassenstab, Jason; Wolf, Oliver T.; Convit, Antonio

2007-01-01

A deficit in empathy has consistently been cited as a central characteristic of Asperger syndrome (AS), but previous research on adults has predominantly focused on cognitive empathy, effectively ignoring the role of affective empathy. We administered the Interpersonal Reactivity Index (IRI), a multi-dimensional measure of empathy, and the Strange…

Development of an Introductory Course in Periodontics with a Strong Behavioral Orientation.

ERIC Educational Resources Information Center

Baab, David; Weinstein, Philip

1983-01-01

Development of a course designed to help dental students integrate interpersonal and clinical skills to help periodontal patients accept and adhere to long-term self-care regimens is described. An algorithm illustrates to students the process of plaque control and the patient's role. (MSE)

The influence of patient acuity on satisfaction with emergency care: perspectives of family, friends and carers.

PubMed

Ekwall, Anna; Gerdtz, Marie; Manias, Elizabeth

2008-03-01

To investigate the factors that influence satisfaction with emergency care among individuals accompanying patients to the emergency department and explore agreement between the triage nurse and accompanying person regarding urgency. Many patients seeking treatment in hospital are escorted by an accompanying person, who may be a friend, family member or carer. Several factors influence patient satisfaction with emergency care, including waiting time and time to treatment. It is also influenced by provision of information and interpersonal relations between staff and patients. Research on satisfaction has focused on the patient perspective; however, individuals who accompany patients are potential consumers. Knowledge about the ways accompanying persons perceive the patient's medical condition and level of urgency will identify areas for improved patient outcomes. A prospective cross-sectional survey with a consecutive sample (n = 128 response rate 83.7%) was undertaken. Data were collected in an Australian metropolitan teaching hospital with about 32,000 visits to the emergency department each year. The Consumer Emergency Satisfaction Scale was used to measure satisfaction with nursing care. Significant differences in perceptions of patient urgency between accompanying persons and nurses were found. Those people accompanying patients of a higher urgency were significantly more satisfied than those accompanying patients of a lower urgency. These results were independent of real waiting time or the accompanying person's knowledge of the patients' triage status. In addition, older accompanying persons were more satisfied with emergency care than younger accompanying persons. Little attention has been paid to the social interactions that occur between nurses and patients at triage and the ways in which these interactions might impact satisfaction with emergency care. Good interpersonal relationships can positively influence satisfaction with the emergency visit. This relationship can contribute to improved patient care and health outcomes.

Managing uncertainty: a grounded theory of stigma in transgender health care encounters.

PubMed

Poteat, Tonia; German, Danielle; Kerrigan, Deanna

2013-05-01

A growing body of literature supports stigma and discrimination as fundamental causes of health disparities. Stigma and discrimination experienced by transgender people have been associated with increased risk for depression, suicide, and HIV. Transgender stigma and discrimination experienced in health care influence transgender people's health care access and utilization. Thus, understanding how stigma and discrimination manifest and function in health care encounters is critical to addressing health disparities for transgender people. A qualitative, grounded theory approach was taken to this study of stigma in health care interactions. Between January and July 2011, fifty-five transgender people and twelve medical providers participated in one-time in-depth interviews about stigma, discrimination, and health care interactions between providers and transgender patients. Due to the social and institutional stigma against transgender people, their care is excluded from medical training. Therefore, providers approach medical encounters with transgender patients with ambivalence and uncertainty. Transgender people anticipate that providers will not know how to meet their needs. This uncertainty and ambivalence in the medical encounter upsets the normal balance of power in provider-patient relationships. Interpersonal stigma functions to reinforce the power and authority of the medical provider during these interactions. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. However, these theories ignore how hierarchies of power in social relationships serve to maintain and reinforce inequalities. The findings of this study suggest that interpersonal stigma also functions to reinforce medical power and authority in the face of provider uncertainty. Within functional theories of stigma, it is important to acknowledge the role of power and to understand how stigmatizing attitudes function to maintain systems of inequality that contribute to health disparities. Published by Elsevier Ltd.

What does patient feedback reveal about the NHS? A mixed methods study of comments posted to the NHS Choices online service

PubMed Central

Brookes, Gavin; Baker, Paul

2017-01-01

Objective To examine the key themes of positive and negative feedback in patients’ online feedback on NHS (National Health Service) services in England and to understand the specific issues within these themes and how they drive positive and negative evaluation. Design Computer-assisted quantitative and qualitative studies of 228 113 comments (28 971 142 words) of online feedback posted to the NHS Choices website. Comments containing the most frequent positive and negative evaluative words are qualitatively examined to determine the key drivers of positive and negative feedback. Participants Contributors posting comments about the NHS between March 2013 and September 2015. Results Overall, NHS services were evaluated positively approximately three times more often than negatively. The four key areas of focus were: treatment, communication, interpersonal skills and system/organisation. Treatment exhibited the highest proportion of positive evaluative comments (87%), followed by communication (77%), interpersonal skills (44%) and, finally, system/organisation (41%). Qualitative analysis revealed that reference to staff interpersonal skills featured prominently, even in comments relating to treatment and system/organisational issues. Positive feedback was elicited in cases of staff being caring, compassionate and knowing patients’’ names, while rudeness, apathy and not listening were frequent drivers of negative feedback. Conclusions Although technical competence constitutes an undoubtedly fundamental aspect of healthcare provision, staff members were much more likely to be evaluated both positively and negatively according to their interpersonal skills. Therefore, the findings reported in this study highlight the salience of such ‘soft’ skills to patients and emphasise the need for these to be focused upon and developed in staff training programmes, as well as ensuring that decisions around NHS funding do not result in demotivated and rushed staff. The findings also reveal a significant overlap between the four key themes in the ways that care is evaluated by patients. PMID:28450463

Assessing the effectiveness of interpersonal communication skills training on job satisfaction among nurses in Al-Zahra Hospital of Isfahan, Iran.

PubMed

Dehaghani, Abdollah Rezaei; Akhormeh, Kobra Ahmadi; Mehrabi, Tayyebeh

2012-05-01

The worldwide nursing shortage is threatening the quality of healthcare. The two most common causes in maintaining nurses are job satisfaction, a positive working environment, and good relationships among staff. This study aimed to determine the effect of interpersonal communication skills training on job satisfaction among the nurses working in Al-Zahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2011. This study was a quasi-experimental research with two groups and two phases, and was carried out on 70 nurses from Al-Zahra University Hospital. Only nurses who had been employed for more than one year were accepted into the study. There were 35 nurses in the test group and 35 nurses in the control group. The study questionnaire included personal details and job satisfaction scale by Smith and Kendall. Sampling was done randomly and nurses were divided into test and control groups. In the test group, the communication skills training program was done in 6 sessions, twice a week and each session was held for 2 hours. The questionnaire was completed in two stages; before, and two months after the study. Data were analyzed by descriptive and inferential statistics through SPSS Software version 18. Findings showed that pre-intervention mean score of job satisfaction of nurses in both groups had no significant difference (p = 0.92). After the communication skills training program in the experimental group, mean score of job satisfaction increased and it was significant compared to the control group (p < 0.01). The data analysis showed that the interpersonal communication skills training program increased the mean score of job satisfaction in the test group. Therefore, it seems necessary that nursing managers design training programs for them.

Assessing the effectiveness of interpersonal communication skills training on job satisfaction among nurses in Al-Zahra Hospital of Isfahan, Iran

PubMed Central

Dehaghani, Abdollah Rezaei; Akhormeh, Kobra Ahmadi; Mehrabi, Tayyebeh

2012-01-01

Background: The worldwide nursing shortage is threatening the quality of healthcare. The two most common causes in maintaining nurses are job satisfaction, a positive working environment, and good relationships among staff. This study aimed to determine the effect of interpersonal communication skills training on job satisfaction among the nurses working in Al-Zahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2011. Materials and Methods: This study was a quasi-experimental research with two groups and two phases, and was carried out on 70 nurses from Al-Zahra University Hospital. Only nurses who had been employed for more than one year were accepted into the study. There were 35 nurses in the test group and 35 nurses in the control group. The study questionnaire included personal details and job satisfaction scale by Smith and Kendall. Sampling was done randomly and nurses were divided into test and control groups. In the test group, the communication skills training program was done in 6 sessions, twice a week and each session was held for 2 hours. The questionnaire was completed in two stages; before, and two months after the study. Data were analyzed by descriptive and inferential statistics through SPSS Software version 18. Findings: Findings showed that pre-intervention mean score of job satisfaction of nurses in both groups had no significant difference (p = 0.92). After the communication skills training program in the experimental group, mean score of job satisfaction increased and it was significant compared to the control group (p < 0.01). Conclusions: The data analysis showed that the interpersonal communication skills training program increased the mean score of job satisfaction in the test group. Therefore, it seems necessary that nursing managers design training programs for them. PMID:23833629

Examining Factors in the Research Institute on Addictions Self-Inventory (RIASI): Associations with Alcohol Use and Problems at Assessment and Follow-Up

PubMed Central

Mann, Robert E.; Stoduto, Gina; Zalcman, Rosely Flam; Nochajski, Thomas H.; Hall, Louise; Dill, Patricia; Wells-Parker, Elisabeth

2009-01-01

Impaired driving is a leading cause of alcohol-related deaths and injuries. Rehabilitation or remedial programs, involving assessment and screening of convicted impaired drivers to determine problem severity and appropriate programs, are an important component of society’s response to this problem. Ontario’s remedial program, Back on Track (BOT), involves an assessment process that includes administration of the Research Institute on Addictions Self-Inventory (RIASI) to determine assignment to an education or treatment program. The purpose of this study is to identify factors within the RIASI and examine how factor scores are associated with alcohol use and problem indicators at assessment and six-month follow-up. The sample included 22,298 individuals who completed BOT from 2000 to 2005. Principal component factor analysis with varimax rotation was conducted on RIASI data and an eight factor solution was retained: (1) Negative Affect, (2) Sensation Seeking, (3) Alcohol-Quantity, (4) Social Conformity, (5) High Risk Lifestyle, (6) Alcohol Problems, (7) Interpersonal Competence, and (8) Family History. Regression analyses were conducted to examine associations between factors and alcohol and problem measures obtained at assessment and at follow-up. Most factors, except for Interpersonal Competence, were associated with more alcohol use and problems at assessment. A similar pattern was observed at 6-month follow-up, but interestingly some factors (Negative Affect, Sensation Seeking, Alcohol-Quantity and Family History) predicted fewer days of alcohol use. The Interpersonal Competence factor was associated with significantly lower levels of alcohol use and problems at both assessment and follow-up. This work suggests that the RIASI provides information on several domains that have important relationships with alcohol problem severity and outcomes. PMID:20049234

The impact on condom use of the "100% Jeune" social marketing program in Cameroon.

PubMed

Meekers, Dominique; Agha, Sohail; Klein, Megan

2005-06-01

To measure the reach of the "100% Jeune" social marketing campaign and to assess its impact on condom use and on the predictors of condom use. The campaign aims to improve condom use through intensive youth-oriented mass media and interpersonal communications and widespread distribution of subsidized condoms. We analyzed data from the 2000 and 2002 waves of a reproductive health survey of youth aged 15-24 years, with sample sizes of 2097 and 3536, respectively. Exposure to campaign activities was high. During the course of the intervention, there were significant changes in perceived condom attributes and access, self-efficacy, and perceived social support. Consistent with these changes, the percentage of youth who used a condom in last sex with their regular partner increased from 32% to 45% for females (p < .05) and from 44% to 61% for males (p < .01). Additional analyses suggest that exposure to the "100% Jeune" campaign has contributed to these trends. The multi-faceted mass media and interpersonal communication campaign was effective for reaching youth. During the first 18 months of the campaign, significant changes occurred in perceived social support and condom use self-efficacy. Significant increases in levels of condom use also were achieved. However, the program was more effective among males than females. This indicates a need for more and possibly different campaign activities to focus specifically on risk perception and self-efficacy among females. The results also show that repeated program exposure is needed to achieve behavior change. Hence, future programs can enhance their effectiveness by using a mix of mass media and interpersonal communications to repeatedly expose youth to key campaign messages.

Customer care in the NHS.

PubMed

Ruddick, Fred

2015-01-20

Viewing individuals in need of NHS care as customers has the potential to refocus the way their care is delivered. This article highlights some of the benefits of reframing the nurse-patient relationship in terms of customer care, and draws parallels between good customer care and the provision of high quality patient care in the NHS. It explores lessons to be learned from those who have studied the customer experience, which can be adapted to enhance the customer care experience within the health service. Developing professional expertise in the knowledge and skills that underpin good-quality interpersonal encounters is essential to improve the customer experience in health care and should be prioritised alongside the development of more technical skills. Creating a culture where emotional intelligence, caring and compassion are essential requirements for all nursing staff will improve patient satisfaction.

Nurturing the Relationships of All Couples: Integrating Lesbian, Gay, and Bisexual Concerns into Premarital Education and Counseling Programs

ERIC Educational Resources Information Center

Casquarelli, Elaine J.; Fallon, Kathleen M.

2011-01-01

Research shows that premarital counseling programs help engaged couples develop interpersonal and problem-solving skills that enhance their marital relationships. Yet, there are limited services for same-sex couples. This article assumes an integrated humanistic and social justice advocacy stance to explore the needs of lesbian, gay, and bisexual…

Empathy for Interpersonal Peace: Effects of Peace Education on Empathy Skills

ERIC Educational Resources Information Center

Sagkal, Ali Serdar; Turnuklu, Abbas; Totan, Tarik

2012-01-01

The purpose of this research was to examine the effects of Peace Education Program on the sixth grade elementary students' empathy levels. The research was carried out using pretest-posttest control group quasi-experimental design. While Peace Education Program was applied on experiment group; control group has not been provided any treatment. The…

A One-Size Relationship Stance Does Not Fit All: Customisation of the Counselling Relationship

ERIC Educational Resources Information Center

Hatchett, Gregory T.

2008-01-01

Many counsellor education programs require students to undergo intensive training in basic interpersonal skills, such as reflection and summarisation. Not only has research failed to demonstrate the value of such skills in improving client outcomes, but the nondirective counselling philosophy upon which many of the programs are based may be…

Activating Interpersonal Influence in Health Promotion: A Field Test of Iowa's Program Against Smoking.

ERIC Educational Resources Information Center

Burke, Julie A.; And Others

This study examined a smoking intervention program, which employed group competitions with rewards, to determine its effects on adolescents' smoking-relevant beliefs, their subjective norms, and peer influence. Initially, 1,187 seventh graders in Burlington, Clinton, and Muscatine, Iowa were surveyed in 1984. Data were gathered from a re-survey…

Preventing Boys' Problems in Schools through Psychoeducational Programming: A Call to Action

ERIC Educational Resources Information Center

O'Neil, James M.; Lujan, Melissa L.

2009-01-01

Controversy currently exists on whether boys are in crises and, if so, what to do about it. Research is reviewed that indicates that boys have problems that affect their emotional and interpersonal functioning. Psychoeducational and preventive programs for boys are recommended as a call to action in schools. Thematic areas for boys' programming…

Family Life and Human Development (Sex Education): The Prince George's County Public Schools Experience.

ERIC Educational Resources Information Center

Schaffer, Michael J.

1981-01-01

The Prince George's County schools' sex education program for grades K-12 was developed and implemented in the late 1960s and has three focus areas: family life and interpersonal relationships; the physiological and personality changes during puberty; and advanced physiology and psychology of human sexual behavior. The program augments what the…

Social Development Training Project. Stage I and Stage II. [The Granville Project].

ERIC Educational Resources Information Center

Riches, Vivienne C., Ed.

The book presents a training program developed at the Granville Work Preparation Centre in Australia, to teach mildly retarded adolescents basic social skills and competencies. The program is divided into two stages, with a total of 17 different skill areas. Stage 1 covers self-awareness, social/interpersonal skills, relaxation and behavioral self…

Communication Skills for Career Success. A Programmed Textbook. Book II: Assertive Communication.

ERIC Educational Resources Information Center

Lombana, Judy H.; Pratt, Phillip A.

This programmed text for self-study provides information on assertive communication in business. Part of a series of such texts, the book presents examples of familiar work situations involving interpersonal problems. The text then discusses each of the answers and explains why one or the other is appropriate for communicating assertively. Some of…

Reduced reciprocal giving in social anxiety - Evidence from the Trust Game.

PubMed

Anderl, Christine; Steil, Regina; Hahn, Tim; Hitzeroth, Patricia; Reif, Andreas; Windmann, Sabine

2018-06-01

Social anxiety is known to impair interpersonal relationships. These impairments are thought to partly arise from difficulties to engage in affiliative interactions with others, such as sharing favors or reciprocating prosocial acts. Here, we examined whether individuals high compared to low in social anxiety differ in giving towards strangers in an economic game paradigm. One hundred and twenty seven non-clinical participants who had been pre-screened to be either particularly high or low in social anxiety played an incentivized Trust Game to assess trustful and reciprocal giving towards strangers in addition to providing information on real life interpersonal functioning (perceived social support and attachment style). We found that reciprocal, but not trustful giving, was significantly decreased among highly socially anxious individuals. Both social anxiety and reciprocal giving furthermore showed significant associations with self-reported real life interpersonal functioning. Participants played the Trust Game with the strategy method; results need replication with a clinical sample. Individuals high in social anxiety showed reduced reciprocal, but intact trustful giving, pointing to a constraint in responsiveness. The research may contribute to the development of new treatment and prevention programs to reduce the interpersonal impairments in socially anxious individuals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Student Perceptions of Their Biology Teacher's Interpersonal Teaching Behaviors and Student Achievement

NASA Astrophysics Data System (ADS)

Madike, Victor N.

Inadequate student-teacher interactions in undergraduate courses have been linked to poor student performance. Researchers have noted that students' perceptions of student-teacher relationships may be an important factor related to student performance. The administration of a Mid-Atlantic community college prioritized increasing undergraduate biology student performance. The purpose of this quantitative study was to examine the relationship between students' biology achievement and their perceptions of interpersonal teaching behaviors and student-teacher interactions in introductory biology courses. Leary's theory on interpersonal communication and the systems communication theory of Watzlawick, Beavin, and Jackson served as the theoretical foundation. The Wubbel's Likert-scale questionnaire on student-teacher interactions was administered to 318 undergraduate biology students. Non-parametric Spearman's rank correlations revealed a significant direct correlation between students' grades and their perceptions of teachers' interpersonal teaching behaviors. The relationship between student achievement and students' perceptions of student-teacher interactions prompted the recommendation for additional study on the importance of student-teacher interactions in undergraduate programs. A recommendation for local practice included faculty development on strategies for improving student-teacher interactions. The study's implications for positive social change include increased understanding for administrators and instructors on the importance of teacher-student interactions at the community college level.

Psychological, interpersonal, and clinical factors predicting time spent on physical activity among Mexican patients with hypertension.

PubMed

Ybarra Sagarduy, José Luis; Camacho Mata, Dacia Yurima; Moral de la Rubia, José; Piña López, Julio Alfonso; Yunes Zárraga, José Luis Masud

2018-01-01

It is widely known that physical activity is the key to the optimal management and clinical control of hypertension. This research was conducted to identify factors that can predict the time spent on physical activity among Mexican adults with hypertension. This cross-sectional study was conducted among 182 Mexican patients with hypertension, who completed a set of self-administered questionnaires related to personality, social support, and medical adherence and health care behaviors, body mass index, and time since the disease diagnosis. Several path analyses were performed in order to test the predictors of the study behavior. Lower tolerance to frustration, more tolerance to ambiguity, more effective social support, and less time since the disease diagnosis predicted more time spent on physical activity, accounting for 13.3% of the total variance. The final model shows a good fit to the sample data ( p BS =0.235, χ 2 / gl =1.519, Jöreskog and Sörbom's Goodness of Fit Index =0.987, adjusted modality =0.962, Bollen's Incremental Fit Index =0.981, Bentler-Bonett Normed Fit Index =0.946, standardized root mean square residual =0.053). The performance of physical activity in patients with hypertension depends on a complex set of interactions between personal, interpersonal, and clinical variables. Understanding how these factors interact might enhance the design of interdisciplinary intervention programs so that quality of life of patients with hypertension improves and they might be able to manage and control their disease well.

Beliefs in Chemotherapy and Knowledge of Cancer and Treatment Among African American Women With Newly Diagnosed Breast Cancer.

PubMed

Jiang, Yun; Sereika, Susan M; Bender, Catherine M; Brufsky, Adam M; Rosenzweig, Margaret Q

2016-03-01

To examine beliefs regarding the necessity of chemotherapy and knowledge of breast cancer and its treatment in African American women with newly diagnosed breast cancer, and to explore factors associated with women's beliefs and knowledge.
. Descriptive, cross-sectional study.
. Six urban cancer centers in Western Pennsylvania and Eastern Ohio.
. 101 African American women with newly diagnosed breast cancer. 
. Secondary analysis using baseline data collected from participants in a randomized, controlled trial at their first medical oncology visit before the first cycle of chemotherapy.
. Belief in chemotherapy, knowledge of cancer and recommended treatment, self-efficacy, healthcare system distrust, interpersonal processes of care, symptom distress, and quality of life.
. African American women endorsed the necessity of chemotherapy. Most women did not know their tumor size, hormone receptors, specific therapy, or why chemotherapy was recommended to them. Women who perceived better interpersonal communication with physicians, less self-efficacy, or were less involved in their own treatment decision making held stronger beliefs about the necessity of chemotherapy. Women without financial difficulty or having stronger social functioning had more knowledge of their cancer and recommended chemotherapy. 
. African American women with newly diagnosed breast cancer generally agreed with the necessity of chemotherapy. Knowledge of breast cancer, treatment, and risk reduction through adjuvant therapy was limited.
. Oncology nurses could help advocate for tailored educational programs to support informed decision making regarding chemotherapy acceptance for African American women.

The impact of undergraduate occupational therapy students' interpersonal skills on their practice education performance: A pilot study.

PubMed

Yu, Mong-Lin; Brown, Ted; White, Carolynne; Marston, Celia; Thyer, Laura

2018-04-01

Interpersonal skills such as active listening, verbal communication and body language are essential competencies for occupational therapists, and students are expected to demonstrate these skills when completing practice placements. To investigate whether interpersonal skills are predictive of occupational therapy students' practice performance. A cross-sectional study was conducted involving third and fourth year occupational therapy undergraduate students (n = 70). Students' interpersonal skills were measured using the Interpersonal Communication Competence Scale (ICCS), Listening Styles Profile (LSP-R) and Active-Empathic Listening Scale (AELS). Students' practice performances at the mid-way and final points of their placements were measured using the Student Practice Evaluation Form-Revised (SPEF-R). The relationships between students' interpersonal skills and practice performance were examined using univariate and multi-variate regressions. Higher ICCS Interaction Management subscale scores predicted better SPEF-R Self-Management Skills at the mid-way point through practice placements (β = 1.93, SE = 0.76), and better Professional Behaviours (β = 1.28, SE = 0.64) and better Service Evaluation Skills (β = 2.84, SE = 0.95) at the final SPEF-R completion point. Higher ICCS Empathy subscale scores predicted lower SPEF-R Documentation scores at the mid-way point (β = -0.81, SE = 0.38), while higher ICCS Supportiveness subscale scores predicted lower mid-way SPEF-R Service Provision scores (β = -2.84, SE = 1.77). No ICCS subscale scores were predictive of the SPEF-R communication, co-worker communication and information gathering subscale scores. As well, LSP-R and AELS subscale scores were not predictive of the SPEF-R subscale scores. While predictive relationships were not found between occupational therapy students' communication, co-worker communication and information gathering skills, this preliminary evidence indicates that students' interpersonal skills (including interaction management and empathetic supportiveness) were predictive of some notable SPEF-R competencies (including Professional Behaviours, Self-Management, Documentation, Service Provision and Service Evaluation). Therefore, students' exposure to professional interpersonal skills should be incorporated into the curriculum of academic education programs with the aim of better preparing them for practice education. © 2018 Occupational Therapy Australia.

Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth.

PubMed

Mastropieri, Biagio; Schussel, Lorne; Forbes, David; Miller, Lisa

2015-06-01

Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy with spiritual visualization (IPT + SV) in group appears to be a feasible and potentially useful treatment option for promoting improved mental health.

Individual versus group female-specific cognitive behavior therapy for alcohol use disorder.

PubMed

Epstein, Elizabeth E; McCrady, Barbara S; Hallgren, Kevin A; Gaba, Ayorkor; Cook, Sharon; Jensen, Noelle; Hildebrandt, Thomas; Holzhauer, Cathryn Glanton; Litt, Mark D

2018-05-01

To test group-based Female-Specific Cognitive Behavioral Therapy (G-FS-CBT) for women with Alcohol Use Disorder (AUD) against an individual Female-Specific Cognitive Behavioral Therapy (I-FS-CBT). This aims of this paper are to describe G-FS-CBT development, content, feasibility, acceptability, group process, engagement in treatment, and within- and post-treatment outcomes. Women with AUD (n=155) were randomly assigned to 12 manual-guided sessions of G-FS-CBT or I-FS-CBT; 138 women attended at least one treatment session. Women in G-FS-CBT attended fewer sessions (M=7.6) than women in I-FS-CBT (M=9.7; p<.001). Women in both conditions reported high satisfaction with the treatments. Independent coders rated high fidelity of delivery of both G-FS-CBT and I-FS-CBT. Therapeutic alliance with the therapist was high in both conditions, with I-FS-CBT being slightly but significantly higher than G-FS-CBT. In the first six weeks of treatment, women in both treatment conditions significantly reduced their percent drinking days (PDD) and percent heavy days drinking (PHD) by equivalent amounts, maintained through the rest of treatment and the 12month follow up with no treatment condition effects. Women reported significant improvement in all but one of the secondary outcomes during treatment; gains made during treatment in depression, anxiety, autonomy, and interpersonal problems were maintained during the follow-up period, while gains made during treatment in use of coping skills, self-efficacy for abstinence, self-care, and sociotropy deteriorated over follow up but remained improved compared to baseline. Findings support the feasibility, acceptability, and efficacy of a group format for female-specific CBT for AUD, a new 12-session, single gender, community friendly, group therapy with programming specifically for women. Similar, positive outcomes for individual and group treatment formats were found for drinking, mood, coping skills, self-confidence, interpersonal functioning, and self-care. Copyright © 2018. Published by Elsevier Inc.

Heterogeneity of emotional and interpersonal difficulties in alcohol-dependence: A cluster analytic approach.

PubMed

Maurage, Pierre; Timary, Philippe de; D'Hondt, Fabien

2017-08-01

Emotional and interpersonal impairments have been largely reported in alcohol-dependence, and their role in its development and maintenance is widely established. However, earlier studies have exclusively focused on group comparisons between healthy controls and alcohol-dependent individuals, considering them as a homogeneous population. The variability of socio-emotional profiles in this disorder thus remains totally unexplored. The present study used a cluster analytic approach to explore the heterogeneity of affective and social disorders in alcohol-dependent individuals. 296 recently-detoxified alcohol-dependent patients were first compared with 246 matched healthy controls regarding self-reported emotional (i.e. alexithymia) and social (i.e. interpersonal problems) difficulties. Then, a cluster analysis was performed, focusing on the alcohol-dependent sample, to explore the presence of differential patterns of socio-emotional deficits and their links with demographic, psychopathological and alcohol-related variables. The group comparison between alcohol-dependent individuals and controls clearly confirmed that emotional and interpersonal difficulties constitute a key factor in alcohol-dependence. However, the cluster analysis identified five subgroups of alcohol-dependent individuals, presenting distinct combinations of alexithymia and interpersonal problems ranging from a total absence of reported impairment to generalized socio-emotional difficulties. Alcohol-dependent individuals should no more be considered as constituting a unitary group regarding their affective and interpersonal difficulties, but rather as a population encompassing a wide variety of socio-emotional profiles. Future experimental studies on emotional and social variables should thus go beyond mere group comparisons to explore this heterogeneity, and prevention programs proposing an individualized evaluation and rehabilitation of these deficits should be promoted. Copyright © 2017 Elsevier B.V. All rights reserved.

Office managers' perception of stress, control, and satisfaction: a comparison between primary care and specialty practices.

PubMed

Chang, Jyh-Hann; Whittier, Nathan; DeFries, Erin; Garfinkle, Amanda

2006-01-01

Perception of stress, control, and satisfaction was measured by office managers in medical practices. Office managers spend enormous amounts of time each day handling difficult interpersonal issues among staff physicians, and patients. As a group, physician disruptions were the most prevalent per day. Other staff members were considered the most stressful by rank order. Significant differences were discovered between primary care practices versus specialty practices in the areas of interactions with physicians.

Emotional Sequelae of Elective Abortion: The Role of Guilt and Shame.

PubMed

Whitney, Donna Krupkin

2017-06-01

Although estimates vary, many women experience long-term emotional, spiritual, psychological and interpersonal difficulties following abortion, including complicated grief, depression, post-traumatic stress disorder (PTSD) and relationship disturbances. Developmental, drive, object-relations and narcissism models for perinatal loss also illuminate the dynamics of post-abortion syndromes. Guilt and shame play important roles in generating and concealing post-abortion sequelae. Pastoral care and healthcare providers can increase their awareness of post-abortion sequelae and provide effective care for women experiencing these syndromes.

Health Care Needs and Care Utilization Among Lesbian, Gay, Bisexual, and Transgender Populations in New Jersey.

PubMed

Qureshi, Rubab I; Zha, Peijia; Kim, Suzanne; Hindin, Patricia; Naqvi, Zoon; Holly, Cheryl; Dubbs, William; Ritch, Wendy

2018-01-01

The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.

Interpersonal art psychotherapy for the treatment of aggression in people with learning disabilities in secure care: a protocol for a randomised controlled feasibility study.

PubMed

Hackett, Simon S; Taylor, John L; Freeston, Mark; Jahoda, Andrew; McColl, Elaine; Pennington, Lindsay; Kaner, Eileen

2017-01-01

Art psychotherapy has greater potential for use with adults with mild to moderate learning disabilities as it places less of a burden on verbal interaction to achieve positive therapeutic, psychological, and behavioural goals. The feasibility study objectives include testing procedures, outcomes, validated tools, recruitment and attrition rates, acceptability, and treatment fidelity for manualised interpersonal art psychotherapy. Adult males and females with mild to moderate learning disabilities will be recruited from four NHS secure hospitals. Twenty patients will be recruited and randomly assigned to one of two treatment groups: fifteen 1-h individual sessions of manualised interpersonal art psychotherapy, or a treatment as usual waiting list control group. The Modified Overt Aggression Scale will be administered to both treatment arms. Four patients will be recruited to a single-case design component of the study exploring the acceptability of an attentional condition. This multi-site study will assist in future trial planning and inform feasibility including, procedures, treatment acceptability, therapist adherence, and estimation of samples size for a definitive RCT.

Why Physicians Don’t Ask: Interpersonal and Intrapersonal Barriers to HIV Testing—Making a Case for a Patient-Initiated Campaign

PubMed Central

Arya, Monisha; Patel, Sajani; Kumar, Disha; Zheng, Micha Yin; Amspoker, Amber Bush; Kallen, Michael Anthony; Street, Richard Lewis; Viswanath, Kasisomayajula; Giordano, Thomas Peter

2014-01-01

In 2006, the US Centers for Disease Control and Prevention recommended HIV testing for all adolescents and adults aged 13 to 64 in health care settings with a HIV prevalence of at least 0.1%. However, 55% of US adults have never been tested and therefore do not know their HIV status. To understand suboptimal HIV testing rates, this study sought to illuminate interpersonal and intrapersonal physician barriers to HIV testing. One hundred and eighty physicians from health centers in Houston completed a survey based on Cabana’s Knowledge, Attitudes and Behaviors model. One-third of the physicians faced at least 1 interpersonal barrier to HIV testing, such as a difference in age or language. Many (41%) physicians faced at least 1 intrapersonal barrier, such as believing their patients would be feeling uncomfortable discussing HIV. Notably, 71% of physicians would prefer their patients ask for the test. A patient-engaging campaign may be an innovative solution to increasing HIV testing and reducing the number of undiagnosed persons. PMID:25421929

Chinese nurse stress in Taiwan, Republic of China.

PubMed

Tsai, S L

1993-01-01

An exploratory study was conducted to understand the Chinese nurses' perceptions of their work stress in Taiwan, Republic of China (ROC). Data were based on the written answers to two open-ended questions from the randomly selected Chinese nurses working at 3 of the 10 first-ranked teaching hospitals that had 900-2,000 hospital beds. The findings showed that stressors in work situations for Chinese nurses were similar to those of their Western colleagues in four categories: nursing care related to patient condition, interpersonal relationships, workload, and opportunity for promotion. In addition, the Chinese respondents especially identified pressure in the role of a unit educator as stressful. Any troubled interpersonal relationship of the Chinese nurse may have been experienced as a greater source of pressure than nurses in other cultures. It is suggested that there might be some similar stressors in the nurse work situation when comparing the Chinese nurse working in the modern hospital in Taiwan to the nurses in large hospitals in the Western culture. Yet the difference between these nurses was the greater emphasis the Chinese nurses placed on the value of advanced study and interpersonal harmony.

Why Physicians Don't Ask: Interpersonal and Intrapersonal Barriers to HIV Testing-Making a Case for a Patient-Initiated Campaign.

PubMed

Arya, Monisha; Patel, Sajani; Kumar, Disha; Zheng, Micha Yin; Kallen, Michael A; Street, Richard L; Viswanath, Kasisomayajula; Giordano, Thomas P

2016-07-01

In 2006, the US Centers for Disease Control and Prevention recommended HIV testing for all adolescents and adults aged 13 to 64 in health care settings with a HIV prevalence of at least 0.1%. However, 55% of US adults have never been tested and therefore do not know their HIV status. To understand suboptimal HIV testing rates, this study sought to illuminate interpersonal and intrapersonal physician barriers to HIV testing. One hundred and eighty physicians from health centers in Houston completed a survey based on Cabana's Knowledge, Attitudes and Behaviors model. One-third of the physicians faced at least 1 interpersonal barrier to HIV testing, such as a difference in age or language. Many (41%) physicians faced at least 1 intrapersonal barrier, such as believing their patients would be feeling uncomfortable discussing HIV. Notably, 71% of physicians would prefer their patients ask for the test. A patient-engaging campaign may be an innovative solution to increasing HIV testing and reducing the number of undiagnosed persons. © The Author(s) 2014.

Interpersonal violence in the United Arab Emirates.

PubMed

Osman, Ossama T; Abbas, Alaa K; Eid, Hani O; Salem, Mohamed O; Abu-Zidan, Fikri M

2014-01-01

We aimed to study the anatomical distribution, severity and outcome of hospitalised interpersonal violence-related injured patients in Al-Ain, United Arab Emirates so as to give recommendations regarding the magnitude of this problem, its causes and priorities of prevention. Data were retrieved from Al-Ain Hospital Trauma Registry, which was prospectively collected over three years. There were 75 patients (males = 85.3%) having a mean age of 30 years. Eighty-one percent had blunt trauma. The estimated annual injury hospitalisation of interpersonal violence in Al-Ain city was 6.7 per 100,000 population. Females were significantly more injured by a family member (p = 0.02), at home (p = 0.005), and had more severe injuries (p = 0.003). There was a trend for children less than 18 years old to have more penetrating trauma (p = 0.06) and to be injured by a family member (p = 0.09). There was only one case of woman sexual assault and two cases of child abuse. The mean (SD) hospital stay was 7.87 (14.1) days. Less than 3% (n = 2) were admitted to the intensive care unit with no deaths. In conclusion, the majority of patients in our study had minor injuries. Nevertheless, the psychological impact may be major. This highlights the need to develop suitable mental health services in support of victims of interpersonal violence.

Adolescent and Young Adult Male Mental Health: Transforming System Failures Into Proactive Models of Engagement.

PubMed

Rice, Simon M; Purcell, Rosemary; McGorry, Patrick D

2018-03-01

Adolescent and young adult men do poorly on indicators of mental health evidenced by elevated rates of suicide, conduct disorder, substance use, and interpersonal violence relative to their female peers. Data on global health burden clearly demonstrate that young men have a markedly distinct health risk profile from young women, underscoring different prevention and intervention needs. Evidence indicates that boys disconnect from health-care services during adolescence, marking the beginning of a progression of health-care disengagement and associated barriers to care, including presenting to services differently, experiencing an inadequate or poorly attuned clinical response, and needing to overcome pervasive societal attitudes and self-stigma to access available services. This review synthesizes key themes related to mental ill health in adolescent boys and in young adult men. Key social determinants are discussed, including mental health literacy, self-stigma and shame, masculinity, nosology and diagnosis, and service acceptability. A call is made for focused development of policy, theory, and evaluation of targeted interventions for this population, including gender-synchronized service model reform and training of staff, including the e-health domain. Such progress is expected to yield significant social and economic benefits, including reduction to mental ill health and interpersonal violence displayed by adolescent boys and young adult men. Copyright © 2018. Published by Elsevier Inc.

"Honey, Won't You Please Stay Home?"

ERIC Educational Resources Information Center

Roach, Rose Marie

1976-01-01

The author examines the stress produced in a "reentry woman's" interpersonal relationships with her husband and family in terms of balance theory. She also offers suggestions as to how colleges might develop programs to help these women. (Author)

An Investigation of the Relationship Between the Alliance Negotiation Scale and Psychotherapy Process and Outcome.

PubMed

Doran, Jennifer M; Safran, Jeremy D; Muran, J Christopher

2017-04-01

This study examines the validity of the Alliance Negotiation Scale (ANS) in a psychotherapy research program. Analyses were designed to evaluate the relationship between the ANS and psychotherapy process and outcome variables. Data were collected in a metropolitan psychotherapy research program. Participants completed 30 sessions of therapy, postsession assessments, and a battery of measures at intake and termination. Relationships were found between the ANS and session outcome, working alliance, and the presence of ruptures and their resolution. Relationships emerged between the ANS and treatment outcome on measures of psychiatric distress and interpersonal problems. The ANS demonstrated relationships with several psychotherapy process and outcome variables. The ANS was the most differentiated from the working alliance on measures of interpersonal functioning and in discriminating personality disorder pathology. These results extend previous findings on the ANS' psychometric integrity, and offer new data on the relationship between negotiation and treatment outcome. © 2016 Wiley Periodicals, Inc.

The association of medical conditions and presenteeism.

PubMed

Burton, Wayne N; Pransky, Glenn; Conti, Daniel J; Chen, Chin-Yu; Edington, Dee W

2004-06-01

A self-reported measure of four domains of work impairment based on the Work Limitations Questionnaire was completed by 16,651 employees of a large financial services corporation. Using a multivariate model to control for coexisting conditions, age, and gender, significant relationships were observed between medical conditions and patterns of impaired work performance. Depression was highly associated with work limitations in time management (odds ratio [OR] = 2.05), interpersonal/mental functioning (OR = 2.50), and overall output (OR = 2.24). Arthritis (OR = 1.56) and low back pain (OR = 1.32) were associated with physical function limitations. These same two conditions were associated with limitations in mental/interpersonal functioning but with low back pain having the higher odds ratio (OR = 1.54 vs. 1.22). These results suggest that worksite interventions (eg, disease management programs) should be tailored to the unique effects observed with specific medical conditions. More targeted programs could have important benefits for productivity in the workplace.

Reductions in aggressive behavior within the context of a universal, social emotional learning program: Classroom- and student-level mechanisms.

PubMed

Portnow, Sam; Downer, Jason T; Brown, Joshua

2018-06-01

The present study uses data from 35 third through fifth-grade urban classrooms and 531 students to examine the extent to which student-level social and emotional skills (e.g., low hostile attribution bias and low aggressive interpersonal negotiation strategies) and emotionally supportive learning environments predict aggressive behavior over the course of a school year. Results of multiple regression analyses indicated that across teacher-reported measures of aggressive behavior, more classroom emotional support over the course of the school year predicted less aggressive behavior in spring, particularly for children whose hostile attribution bias decreased over the course of the year. According to a child-reported measure of aggressive behavior, declines in aggressive interpersonal negotiation strategies over the course of the year also predicted less aggressive behavior in spring. Moreover, these results operated similarly across all children. Implications for SEL programs are discussed. Published by Elsevier Ltd.

I Have Something Interesting To Talk To You About: Speaking To Disagree, Agreeably

PubMed Central

Rockwood, Kenneth

2015-01-01

Working in health care can sometimes be exhilarating. At other times it is exhausting, especially if there is interpersonal conflict amongst health-care providers about the best course of action. This can occur in relation to the care of frail older adults. Physicians and other health-care professionals often are not taught how to disagree. This short essay outlines a few steps that can be followed to allow disagreements to be identified in a respectful manner, focused on a solution that requires something from each side. Given the importance of interdisciplinary collaborative care in geriatric medicine, having a structured approach to disagreement is likely to be a useful tool in the geriatrician’s kit. PMID:26180564

Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial.

PubMed

van Veen, Mark; Koekkoek, Bauke; Mulder, Niels; Postulart, Debby; Adang, Eddy; Teerenstra, Steven; Schoonhoven, Lisette; van Achterberg, Theo

2015-05-02

This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study. Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18-65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts. No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care. Netherlands Trial Register (NTR): 3988 . Registered 13th of May 2013.

Principles of Training in Marine Corps Task Analysis. Training Manual I. Evaluation of the Marine Corps Task Analysis Program. Technical Report No. 7.

ERIC Educational Resources Information Center

Kuriloff, Arthur H.

This is the first in a series of five training manuals developed for use by the U.S. Marine Corps Office of Manpower Utilization (OMU) in its Task Analysis (TA) program. It is designed for trainers of OMU staff members assigned to the TA program, a research effort requiring interpersonal and research competence. Objectives of the manual are: (1)…

A national survey to define a new core curriculum to prepare physicians for managed care practice.

PubMed

Meyer, G S; Potter, A; Gary, N

1997-08-01

All levels of medical education will require modification to address the challenges in health care practice brought about by managed care. Because preparation for practice in a managed care environment has received insufficient attention, and because the need for change is so great, in 1995 the authors sought information from a variety of sources to serve as a basis for identifying the core curricular components and the staging of these components in the medical education process. This research effort consisted of a survey of 125 U.S. medical school curriculum deans (or equivalent school representatives); four focus groups of managed care practitioners, administrators, educators, and residents; and a survey of a national sample of physicians and medical directors. Findings indicate that almost all the 91 responding school representatives recognized the importance of revising their curricula to meet the managed care challenge and that the majority either had or were developing programs to train students for practice in managed care environments. The focus groups identified a core set of competencies for managed care practice, although numbers differed on whether the classroom or a managed care setting was the best place to teach the components of a new curriculum. Although medical directors and staff physicians differed with respect to the relative levels of importance of these competencies, the findings suggest that before medical school, training should focus on communication and interpersonal skills, information systems, and customer relations; during medical school, on clinical epidemiology, quality assurance, risk management, and decision analysis; during residency, on utilization management, managed care essentials, and multidisciplinary team building; and after residency, on a review of customer relations, communication skills, and utilization management. The authors conclude that a core curriculum and its sequencing can be identified, that the majority of curricular components exist but in s some cases needed to be modified to more clearly relate to managed care practice, and that their findings may provide a useful starting point for making decisions about curricular reform.

Population-based recruitment for quit-smoking programs: an analytic review of communication variables.

PubMed

McDonald, P W

1999-06-01

Attempts to reduce the prevalence of smoking through quit-smoking programs have been unsuccessful because they have not attracted large numbers of smokers to participate in them. An analytic review of the literature was conducted to identify potential communication variables that might enhance recruitment for community-based quit-smoking programs. Recruitment was defined as the number of smokers who enroll in a quit-smoking program divided by the estimated number of smokers in the target population. Thirty-three publications reporting the results of 40 recruitment campaigns were located. The median recruitment rate was 2.0%. Logistic regression was used to examine the effect of six variables on recruitment rate: the type of program sponsor, the type of program, program costs, use of participation incentives, whether messages were segmented by stage of change, and the type of channel used to send messages. The only significant predictor of recruitment rate was channel type (i.e., the method used to deliver a message). Studies that used interactive recruitment channels (telephone, interpersonal communication) were 66.5 times more effective than those using passive recruitment strategies (mass media, direct mail). Results examining the segmentation of messages by stage of change on recruitment were inconclusive. Results suggest that researchers and practitioners interested in population-based smoking cessation programs should pay more attention to recruitment methods. The use of interpersonal channels has been underused and appears to be particularly promising for improving the population impact of quit-smoking programs.

Factors that influence exercise activity among women post hip fracture participating in the Exercise Plus Program.

PubMed

Resnick, Barbara; Orwig, Denise; D'Adamo, Christopher; Yu-Yahiro, Janet; Hawkes, William; Shardell, Michelle; Golden, Justine; Zimmerman, Sheryl; Magaziner, Jay

2007-01-01

Using a social ecological model, this paper describes selected intra- and interpersonal factors that influence exercise behavior in women post hip fracture who participated in the Exercise Plus Program. Model testing of factors that influence exercise behavior at 2, 6 and 12 months post hip fracture was done. The full model hypothesized that demographic variables; cognitive, affective, physical and functional status; pain; fear of falling; social support for exercise, and exposure to the Exercise Plus Program would influence self-efficacy, outcome expectations, and stage of change both directly and indirectly influencing total time spent exercising. Two hundred and nine female hip fracture patients (age 81.0 +/- 6.9), the majority of whom were Caucasian (97%), participated in this study. The three predictive models tested across the 12 month recovery trajectory suggest that somewhat different factors may influence exercise over the recovery period and the models explained 8 to 21% of the variance in time spent exercising. To optimize exercise activity post hip fracture, older adults should be helped to realistically assess their self-efficacy and outcome expectations related to exercise, health care providers and friends/peers should be encouraged to reinforce the positive benefits of exercise post hip fracture, and fear of falling should be addressed throughout the entire hip fracture recovery trajectory.

Associations between School Connection and Depressive Symptoms from Adolescence through Adulthood: The Moderating Influence of Early Adversity

ERIC Educational Resources Information Center

Markowitz, Anna J.

2015-01-01

Depression is the most common psychiatric disorder worldwide. Conservative estimates Suggest that 20% of Americans will experience depression during their lifetime, inflicting high interpersonal, labor market, and health care costs. Although depression is highly heritable, environmental factors can powerfully influence its development both…

CLASS-Infant: An Observational Measure for Assessing Teacher-Infant Interactions in Center-Based Child Care

ERIC Educational Resources Information Center

Jamison, Kristen Roorbach; Cabell, Sonia Q.; LoCasale-Crouch, Jennifer; Hamre, Bridget K.; Pianta, Robert C.

2014-01-01

Research Findings: The growing body of literature demonstrating the importance of quality interactions with caregivers to infant development coupled with the increasing number of infants spending time in classroom settings highlights the need for a measure of interpersonal relationships between infants and caregivers. This article introduces a new…

Stressful Events and Depression among Chinese Adolescents: The Mitigating Role of Protective Factors

ERIC Educational Resources Information Center

Zhang, Wenxin; Li, Hailei; Gong, Yanming; Ungar, Michael

2013-01-01

This study examines the role of salient external factors (family, peer and school caring relations) and internal factors (goals and aspirations, problem solving and self-efficacy, empathy, and self-awareness) in protecting adolescents experiencing interpersonal problems and academic pressure from depression. A total of 1,297 eighth and ninth grade…